Accelerating Post-Surgical Best Practices Using Enhanced Recovery After Surgery
Notice bibliographique
Résumé
Patients undergoing surgery today experience longer hospital stays and more complications because evidence-based practices in the areas of nutrition, activity, opioid-sparing analgesia, hydration and overall best practices are not consistently applied or used.There is also emerging evidence that supporting patients and families to become engaged in their perioperative care improves outcomes.Enhanced Recovery After Surgery (ERAS) helps patients be more prepared for surgery and recover more quickly by bringing patients, healthcare providers and health systems together and creating tools and resources that are based on the most up-to-date evidence.The goal of Enhanced Recovery Canada is to support the uptake of these best practices across Canada, improving patient outcomes and experiences.M rs. Lee awaits colon cancer surgery.Her healthcare/surgery team works with her to identify her concerns and to tailor support through evidencebased pathways to help her prepare mentally and physically (e.g., optimizing her diet, activity and medical conditions), which help ease her worry.She uses a customized tablet-based Enhanced Recovery app to track her symptoms and to know when to eat and drink at all times on her surgical journey.After surgery, she knows what to expect and is ready to move and eat the very same day.She has less nausea and pain than she expected.Mrs. Lee is discharged from hospital only 4 days post-surgery.She continues to use her Enhanced Recovery app and has regular follow-ups, which alleviate her anxiety.Six weeks later, she says she feels ready to start chemotherapy.The surgery team tracks her symptoms, uses appropriate pain and symptom control to optimize her recovery and encourages her to move, avoiding the muscle wasting, weakness and frailty that are a consequence of immobilization.This scenario is a far cry from the present state in Canada.In reality, Mrs. Lee suffered terribly from anxiety and a lack of empowerment.Her pre-surgical period was rife with inconsistent patient information and optimization strategies.She stayed 10 days in hospital and waited 4 weeks for results.Her doctor was equally upset by the gaps in care and unnecessary costs that she felt she was unable to change.The health authority recognized the value of adopting evidence-based practices but had difficulty spreading the implementation of best practices and scaling them up without first addressing buy-in among stakeholders. Enhanced Recovery After SurgeryEnsuring the best outcomes for Mrs. Lee and patients like her led to Enhanced Recovery After Surgery (ERAS).ERAS consists of evidence-based care pathways "designed to achieve early recovery after surgical procedures by maintaining Accelerating Post-Surgical Best Practices Using Enhanced Recovery After Surgery
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,039 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».