A new national guideline has been established in the United Kingdom to “improve care of people with Parkinson’s before, during and after surgery.” The guideline should be of interest to perioperative professionals in the U.S., as well.
Read the guideline—which was developed by the Centre for Perioperative Care (CPOC), hosted by the Royal College of Anaesthetists (RCoA)—along with supporting resources, and associated implementation tools, here.
In its own words, CPOC lists these “key recommendations” of the guideline:
CPOC notes that people with Parkinson’s are admitted to hospitals around 1.5 times more often than their peers, and experience higher rates of perioperative complications, critical care admission and mortality. It adds that “the complex motor and non-motor symptoms associated with Parkinson’s can create significant challenges throughout the perioperative pathway, including effective drinking, eating and mobilizing within 24 hours of surgery. These activities are cornerstones of early postoperative recovery but can be significantly impaired when Parkinson’s medication schedules are disrupted.”
According to CPOC, the guideline highlights “the importance of recognizing Parkinson’s medications as time-critical medicines and provides recommendations to minimize interruptions to treatment.” It “sets out eight standards of care and provides practical recommendations to support uninterrupted treatment, including safe alternative routes for administering medication during [NPO] periods. It also addresses shared decision-making, preoperative assessment, anesthetic considerations, medicines to avoid, deep brain stimulation and other device-aided therapies, swallowing difficulties, postoperative care, and discharge planning.”
The guidelines was developed by a multidisciplinary working group that included anesthesia, surgery, neurosurgery, neurology, geriatric medicine, general practice, emergency medicine, palliative medicine, nursing, pharmacy, physiotherapy, occupational therapy, speech and language therapy, and dietetics, “alongside the insights of people with lived experience of Parkinson’s,” stated CPOC. “The recommendations are intended for all healthcare professionals involved in perioperative care, including general practitioners and primary care teams, anesthetists, surgeons, physicians, nurses, pharmacists, allied health professionals and managers responsible for service delivery.”
