Authors: (including presenting author): :
Lai TY(1) Chan TY(1)
Affiliation: :
(1) Department of Surgery, Princess Margaret Hospital
Keyword 1: :
Standardized
Keyword 2: :
Early intervention
Keyword 3: :
Patient centered
Keyword 4: :
Committed staff
Introduction: :
The management of pre-operative anemia is crucial for optimizing surgical outcomes, yet the effective application of interventions like intravenous iron therapy (Monofer) has often been challenging in clinical practice. This program aimed to standardize a pre-operative anemia pathway within the Enhanced Recovery After Surgery (ERAS) framework. Central to this initiative was the proactive role of ERAS nurses, whose interventions were key to early identification and pre-operative IV iron (Monofer) administration.
Objectives: :
The goal of this initiative, implemented in October 2024, was to optimize anemia management, particularly iron deficiency anemia, through early identification and pre-operative IV iron (Monofer) administration by ERAS nurses.
Methodology: :
A retrospective audit compared data from October 2023 - March 2024 (pre-standardization) to October 2024 - March 2025 (post-standardization). Key metrics included IV Monofer usage, pre-operative hemoglobin (Hb) levels, and peri-operative red blood cell (RBC) transfusions in all ERAS patients and specifically in colorectal and upper gastrointestinal patients.
Result & Outcome: :
1. Increased IV Monofer Usage: Standardization led to a significant increase in IV Monofer prescriptions, particularly in T1 and T3 patients (19 doses vs. 50 doses). 2. Comparable Pre-operative haemoglobin level: Average pre-operative Hb levels showed a modest increase (11.92 g/dL vs. 12.26 g/dL in T1/T3 patients) 3. Reduced Peri-operative Transfusions: A notable 42% decrease in peri-operative RBC transfusions was observed in colorectal and upper gastrointestinal patients after pathway standardization (31 units vs. 18 units).
