Awareness, Knowledge, and Implementation of Enhanced Recovery After Surgery (ERAS) Protocols Among Healthcare Professionals in a Tertiary Care Hospital: A questionnaire-based study

Background: Enhanced Recovery After Surgery (ERAS) protocols constitute multidisciplinary, evidence-based perioperative care pathways aimed at optimizing postoperative outcomes, reducing complications, and shortening hospital stay. This study seeks to assess the level of awareness, knowledge, and implementation of ERAS protocols among healthcare professionals in a tertiary care hospital. Methods: A cross-sectional, questionnaire-based study was conducted among 320 healthcare professionals including surgeons, anaesthesiologists, junior doctors, nurses, and technicians. The validated questionnaire evaluated demographic characteristics, awareness, knowledge, implementation practices, perceived barriers, and educational needs related to ERAS protocols. Data were analyzed using descriptive statistics and chi-square tests, with p <0.05 considered statistically significant. Results: Only 25.9% of participants had received formal ERAS training, and 29.7% were aware of ERAS principles, while adequate knowledge and active implementation were limited to 22.5% and 14.1%, respectively. Surgeons and anaesthesiologists demonstrated higher awareness and practice implementation compared to junior doctors and nursing staff (p <0.05). The most frequently applied components were preoperative counselling (41.3%) and early oral feeding (40.3%), whereas carbohydrate loading (23.8%) and multimodal analgesia (31.6%) were less adopted. Common barriers included lack of knowledge (53.4%), insufficient resources (49.4%), and colleague resistance (44.4%). However, 84.4% expressed interest in receiving further ERAS training, with workshops being the preferred format. Conclusion: The study reveals that while ERAS awareness exists among healthcare providers, knowledge and implementation remain inadequate. Targeted multidisciplinary education, institutional support, and standardized ERAS protocols are essential to bridge the knowledge-practice gap and improve perioperative patient outcomes.