Poster Title: A nurse-led ERAS® program at Charité (CC8) in liver surgery reduces postoperative complications and ICU readmissions.
Organization or Hospital: Charité
Unit: ERAS
Authors: Alexandra Zuehlke, Marlen Charlot Breitkreutz, Bernadette Hagemeister-Wilczek
Conference Name: SANA 2026
Presentation Date: May 12, 2026
Project Summary:
A nurse-led ERAS® program at Charité (CC8) in liver surgery significantly reduces postoperative complications and ICU readmissions. This retrospective analysis (pre-ERAS: n=57; post-ERAS: n=1300, EIAS data) demonstrates that adherence to the ERAS® pathway improved from 43.6% to 70.4%, primarily through newly implemented preoperative measures such as patient and family education, as well as screening and treatment of malnutrition—interventions not previously available in the clinic. Complication rates declined from 49.1% to 31.6%, and ICU readmissions dropped from 36.8% to 19.1%, alongside additional quality improvements including earlier mobilization and oral intake.
Methods:
This retrospective cohort analysis included adult patients (>18 years) undergoing elective liver surgery at Charité Centre 8 (excluding liver transplant recipients, who follow a separate ERAS® protocol), with data captured via the ERAS® Interactive Audit System (EIAS) database. Pre-ERAS (n=57) data were compared to post-implementation in routine care (n=1300).
ERAS® adherence was calculated as the percentage implementation of 28 interventions per patient. Primary endpoints were:
* Perioperative adherence rate
* Postoperative complication rates
* ICU readmissions (during primary stay)
Results:
Adherence increased from 43.6% to 70.4%.
Complication rates fell from 49.1% to 31.6%.
ICU readmissions decreased from 36.8% to 19.1%.
Conclusion:
Sustainable ERAS® implementation demands more than standards: continuous monitoring, nurse-led process control, and advanced nursing competencies are essential. Clinical expertise, interprofessional collaboration, leadership, coaching, and research skills form the foundation.
These findings highlight ERAS® potential in liver surgery: measurable quality gains that foster internal transparency and enable external benchmarking. Nurse-sensitive parameters, such as early oral intake and mobilization, are systematically captured, monitored, and analyzed. Higher adherence directly correlates with improved clinical outcomes, including reduced rates of delirium, pneumonia, ileus, and urinary tract infections, as well as fewer ICU readmissions due to complications.
ERAS® nurses with academic backgrounds (Advanced Practice Nurses) play a pivotal role in holistic patient care, including process oversight, daily rounds, audits/feedback, interprofessional coordination, and 30-day follow-up. This embodies Magnet® principles: empirical outcomes and innovations.
References:
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Contact Person(s):
Alexandra Zühlke | alexandra.zuehlke@charite.de | www.charite.de
Marlen Charlot Breitkreutz | marlen-charlot.breitkreutz@charite.de| www.charite.de