Introduction
St James’s Hospital (SJH) is the largest tertiary referral centre for Head and Neck cancer (HN) in Ireland. Enhanced Recovery After Surgery (ERAS) protocols improve quality of care and optimise outcomes. Within the HN ERAS protocol there are physiotherapy-specific recommendations. The aim of this audit is to examine compliance with SJH HN ERAS physiotherapy recommendations during the first five post-operative days (PODs).
Methods
A retrospective review of fourteen patients undergoing major HN surgery from September to December 2023 was conducted, excluding patients undergoing fibular free flap due to mobilisation restrictions.
Results- In this cohort average age was 64.9 years, 85.7% (n=12) were male, 92.8% (n=13) underwent tracheostomy, 64.3% (n=9) required a period of ventilation in ICU, 64.3% (n=9) were current or recent smokers, and 57% (n=8) had excess alcohol intake.
All patients were reviewed POD1, including a respiratory assessment and 83.3% (n=10/12) sat out of bed. The median day for mobilising was POD2 (range 2-7 days). Six transient adverse events occurred. Only 42.8% (n=6) were reviewed daily from POD1- POD5.
Conclusion
We highlight current strengths and weaknesses in compliance with the SJH HN ERAS protocol physiotherapy requirements. This information will be used to guide improvement and compliance in future.
Joanne Dowds1, Sean McEntagart1, Ciara Walsh2, Conall Fitzgerald3
1 Physiotherapy Department, St James’s Hospital, Dublin
2 Physiotherapy Department, Wexford Hospital, Wexford
3 Department of Otolaryngology/Head & Neck Surgery, St James’s Hospital, Dublin