Objective

This paper provides an overview of the multifarious role of nursing in enhanced recovery after surgery (ERAS) in advanced bladder cancer surgery with procedure-specific recommendations in radical cystectomy pathways.

Data Sources

Electronic databases including PubMed and CINAHL.

Conclusion

The growing evidence of preoperative, perioperative, and postoperative interventions and the concept of reacting proactively in ERAS, has led to the paradigm shift in the surgical pathway with establishment of nurse-led multi-professional prehabilitation academies. Moreover, although most patients will recover in real-life at home, there is a need for a change in postoperative and discharge management. Thus, a highly skilled discharge nurse is required to secure a comprehensive, safe discharge plan adjusted to the patient's needs in close cooperation with the primary care setting, family, and survivorship clinic if needed. Limited efforts have been made to evaluate rational principles and goals for rehabilitation after radical cystectomy; an important issue with major patient and perhaps socioeconomic consequences, wherein the ERAS nurse may take the future lead.

Implication for Nursing Practice

It has become a governmental demand in many countries to involve the patient and family in treatment decisions and care by using shared decision tools, and to educate and inform each family in concordance with the patient's needs and preferences, and the health care systems must react accordingly. However, to provide person-centeredness care within advanced surgical pathways, there remains a need for thought-leaders, strategic planners, managers, and decision-makers to anchor the process of change and stop “we do it anyway” arguments to defend organizational cultures that are not conducing the evidence-recommend practice.

中文翻译：

---

ERAS 膀胱癌通路中的组织因素：ERAS 护士的多种作用，为什么以及什么是重要的？

客观的

本文概述了护理在晚期膀胱癌手术中加速康复外科 (ERAS) 中的多重作用，并提供了根治性膀胱切除术路径中的手术特定建议。

数据源

包括 PubMed 和 CINAHL 在内的电子数据库。

结论

越来越多的证据表明术前、围术期和术后干预措施以及在 ERAS 中积极反应的概念，导致了外科手术路径的范式转变，建立了以护士为主导的多专业康复学院。此外，虽然大多数患者在现实生活中会在家中康复，但术后和出院管理需要改变。因此，需要一名技术娴熟的出院护士，在需要时与初级保健机构、家庭和幸存者诊所密切合作，以确保根据患者的需求制定全面、安全的出院计划。评估根治性膀胱切除术后康复的合理原则和目标的努力有限；一个具有重大患者和社会经济后果的重要问题，

对护理实践的启示

许多国家的政府要求通过使用共享决策工具让患者和家属参与治疗决策和护理，并根据患者的需求和偏好对每个家庭进行教育和通知，卫生保健系统必须做出相应的反应。 . 然而，为了在先进的外科手术路径中提供以人为本的护理，仍然需要思想领袖、战略规划者、管理者和决策者来锚定变革的过程并停止“我们无论如何都要这样做”的论点来捍卫组织文化不进行证据推荐实践。