Implementing a Frailty-Specific Postoperative Order Set to Improve Postoperative Outcomes in Frail Adults After Elective Thoracic Surgery.

BACKGROUND

Frailty is independently associated with adverse patient outcomes after surgery. The current standards of postoperative care rarely consider frailty status.

LOCAL PROBLEM: There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.

METHODS

A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.

INTERVENTIONS: A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.

RESULTS

There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).

CONCLUSIONS

Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.