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The Enhanced Recovery Programme

This is an evidenced based approach to help people recover more quickly after major surgery.

Originally pioneered in Denmark, the programme is now used in most elective surgery centres in the UK.

Promoted by the Enhanced Recovery Team of specialist nurses over the last 3 years at Wrightington, this is now the established model of care for the majority of our patients undergoing primary hip and knee replacement surgery.

The programme requires the patient to:

  • Play an active role in your treatment (take a look at the ‘My Role and My Responsibilities’ leaflet) and work with the healthcare teams to optimise your health before and after surgery.
  • Understand your operation – what will it really mean once you wake up and start recovery aswell as in the longer term. Ask the teams (contact details below) and read the Enhanced Recovery Programme information leaflets:
  • Remember to eat well, keep fit, sleep well, lose weight, stop smoking and limit alcohol.
  • See your GP or practice nurse once you have been listed for an operation for help and to ensure your health is the best it can be, including your mental health.
  • Prepare your family and friends so they can support you in the early weeks of recuperation if they can. Think about needing help from social services, could this apply to you?

The hospital has various teams to help prepare you for surgery:

  • Out patient Surgeon and staff – start you on your journey
  • Pre op assessment nurses – ensure you are medically ‘fit’ , keep you informed and help you understand the process, refer you to specialist help if required - for example the Pain Team
  • Anaesthetist – ensures you have appropriate anaesthesia and pain relief
  • Physiotherapists –provide information regarding mobility and exercise and provide walking aids if required
  • Occupational Therapists – provide information to ensure you are as independent as possible and you can safely manage at home after discharge
  • Patient Flow team – provides specialist help for those with more complex needs and prepares for any social service referrals after surgery
  • Admission nurses – make sure you remain fit for your operation , keep you warm, ensuring you have not fasted for too long prior to you operation, give you pre op medication

Various techniques are used during the operation:

  • Direct wound analgesia for pain relief
  • Minimal use of tubes into your body
  • Minimise blood loss
  • Specialised wound dressing

After the operation the ward teams are proactive in your recovery by:

  • Regular monitoring of your condition
  • Keeping you warm and comfortable
  • Encouraging food and drink as soon as possible
  • Depending on your operation and surgeon, you may have your operated leg wrapped and cooled through a system called ‘Game Ready’. This helps minimise pain and swelling, assisting your recovery and rehabilitation. For further information click on this link: www.gameready.co.uk
  • Encouraging movement including walking if possible from 4 hours after your operation
  • Encouraging you to get yourself washed and dressed the next day
  • Ensuring you are safely up and about and ready for home by day 3.

The outcome from the patient experience survey was extremely positive. Click here to see the results.

For further information the lead nurse for the programme is Sister Julie Bolt who can be contacted on
01257 488280

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