The Enhanced Recovery Programme for stoma patients: an audit.

An enhanced recovery programme was implemented at Salisbury NHS Foundation Trust for elective patients undergoing colonic surgery with a stoma in October 2007. The programme is a multimodal approach first described by Professor H. Kehlet in 2000. In order for ERP to be successful in reducing length of stay and promoting earlier stoma independence, there was a need to educate, inform and prepare patients comprehensively in the pre-operative phase to enhance their understanding. A change of practice was necessary as, traditionally, the majority of practical and psychological care was promoted in the post-operative phase. A retrospective audit was carried out on 20 patients before undertaking the enhanced recovery programme, and 20 patients afterwards, which demonstrated a reduction in the patients' mean length of stay from 20 to 7 days, with 60% being discharged at 5 days or less after the programme. The mean number of days until stoma-independent decreased from 12 to 5 days as a result of the enhanced recovery programme. A further 40 patients have been audited.