Date

12-4-2025

Department

School of Nursing

Degree

Doctor of Nursing Practice (DNP)

Chair

Cynthia Goodrich

Keywords

enhanced recovery after surgery (ERAS), cesarean section, maternal pain management, evidence-based practice, postoperative outcomes

Disciplines

Nursing

Abstract

Cesarean sections remain the most common surgical procedures in the United States, but they come with significant risks, including increased pain, infection, longer recovery, and higher health care costs. Enhanced Recovery After Surgery (ERAS) guidelines outline an evidence- based, multidisciplinary approach that optimizes surgical recovery and improves outcomes. The primary goal of this project was to evaluate the impact of the implementation of ERAS guidelines in a community hospital with women undergoing scheduled cesarean sections on postoperative pain management as measured by aggregate pain scores. The Iowa Model of Evidence-Based Practice was used to guide this quasi-experimental pre-post project, which assessed outcomes for women undergoing scheduled cesarean sections related to pain scores, patient satisfaction, and length of stay. The literature appraisal revealed consistent findings that ERAS decreases postoperative pain, reduces opioid use, shortens hospital stays, and enhances maternal satisfaction. However, the results from this project do not reflect ERAS implementation as effective improving maternal recovery post cesarean delivery. Average pain scores, pro re nata (PRN) pain medication administration, PRN opioid administration, and length of stay increased despite ERAS implementation. Patient satisfaction scores demonstrated a positive correlation to ERAS implementation. Lack of physician buy-in, improper documentation, and improper orders were limitations observed, indicating a need to re-educate and modify documentation and processes for re-implementation.

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