Developmental and Evaluation of the Use of Nursing Practice Guideline in Patients with Total Knee Arthroplasty
Article Sidebar
Main Article Content
Abstract
This research and development study aimed to develop and evaluate clinical nursing practice guidelines (CNPG) for patients undergoing total knee arthroplasty.Soukup’s evidence-based practice model was used to develop the CNPG. This study included 30 registered nurses working at inpatient wards and 30 patients undergoing total knee arthroplasty and admitted to inpatient wards at a tertiary care hospital in Bangkok. The research instruments included the Nursing Practice Guidelines for Patients with Total Knee Arthroplasty and a process evaluation form for nurses using the CNPG.The contents of CNPG for patients undergoing total knee arthroplasty comprised three phases: 1) pre-operative phase, 2) post-operative phase, and 3) before and after discharge from the hospital phase. Data were analyzed using descriptive statistics. The process evaluation showed that nurses rated as good on satisfaction and reported that the CNPG was feasible to continue implementing in the clinic. For patients, the clinical
outcomes were good; the average pain score was less than three points in the three phases.Patients had an improvement in knee flexion. All patients were able to walk for more than 20 meters. The mean length of hospital stay was 2.98 days. It also leads to
satisfaction with the quality of nursing care. The results indicated that the clinical nursing practice guidelines are feasible to use in patients with total knee arthroplasty for achieving the nursing care quality; however, it may be modified to each context, as necessary.
Keywords: Development and evaluation, Clinical nursing practice guidelines, Evidencebased
practice model, Total knee arthroplasty
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
References
Ashkavand Z, Malekinejad H, Vishwanath BS. The pathophysiology of osteoarthritis. Phram Res.2013;7(1);132-8. doi:org/10.1016/j.jopr.2013.01.008
Jenkin JB, McCoy TP. Symptom clusters, functional status,and quality of life in older adults with osteoarthritis. Orthop Nus. 2015;34(1):36-42. doi:10.1097/NOR.0000000000000112
Smith DM, Parmeelee PA. Within-Day variability of fatigue and pain among African American and non-Hispanic whites with osteoarthritis of the knee. Arthritis Care Res. 2016;68(1):115-22. doi: 10.1002/acr.22690
Youngcharoen P, Hershberger PE, Aree-Ue S. Pain in elderly patients with knee osteoarthritis: an integrative review of psychosocial factors. Int J Orthop Trauma Nurs.2017;25(1):19-28.
Centers for Diseases Control and Prevention. Osteoarthritis.[Internet]. 2020 [cited 2020 Sep12], Available from:http://cdc.com gov/arthritis basics/osteoarthritis.htm
National Health Security Office (NHSO). Total knee arthroplasty surgery. [Internet]. 2020 [cited 2020 Sep12],Available from: https://www.nhso.go.th.
Faculty of Medicine Ramathibodi Hospital. Statistics of total knee arthroplasty surgery. [Internet]. 2020 [cited 2020 April 12], Available from: https://intra9.rama.mahidol.ac.th
Wu C, Chen I, Wang J, Ko J, Wang C, Lee C.Complications - Infection: Surgical Site Infection After Total Knee Arthroplasty: Risk Factors in Patients with Timely Administration of Systemic Prophylactic Antibiotics. J Arthroplasty. 2016;31(1):1568-73. doi:10.1016/j.arth.2016.01.017
Lingle M. Peri-oprative process change to reduce the risk of post-operative Infection following orthopedic procedures. [Internet].2012.[cited 2020 Sep12],Available from website: www.medlineuniversity.com
Clionac FS, Anastase DM, Munteanu AM, Stoica IC,Antonescu D. Venous Thromboembolism Following Major Orthopedic Surgery. Mædica. 2013;8(2):189–94.
Parks-Chapman JRB, Schub ERB. Total knee arthroplasty.CINAHL Nursing Guide 2018 [cited 2019 Apr 29],Available from: https://search-ebscohost-com.ejournal.mahidol.ac.th
Chen SR, Chen CS, Lin PC. The effect of educational intervention on the pain and rehabilitation performance of patients who undergo a total knee replacement. J Clin Nurs.2014;23(4):279–87. doi: 10.1111/jocn.12466
Konchan S, Namjuntra R. Effectiveness of pain management and rehabilitation program among patients
receiving total knee arthroplasty. Christian University Journal. 2019;25(3):64-77. (in Thai)
Nakpalad W, Khunpantavee N, Sangchan H. The development and evaluation of clinical nursing practice guideline for promoting and recovery of older patients with total knee arthroplasty. Journal of the Police Nurses.2019;11(1):73-85. (in Thai)
Swangnade N, Binhosen V, Pakdevong N. Effects of clinical practice guideline implementation for patients undergoing total knee arthroplasty. Journal of Nursing and Health Sciences. 2019; 13(2):101-112. (in Thai)
Polkaew J, Rodpal J. A result of preparation program of knee replacement surgery to an anxiety of the elderly
patients with knee osteoarthritis. Journal of Prevention Medicine Association of Thailand. 2018;7(3):251-56.(in Thai)
Baker M, Preez M, Barlow R. How to Guide Enhanced Recovery after Surgery (Hip and Knee Joint Arthroplasty)[Internet]. 2012 [cited 2018 Sep12], Available from website: www.1000livesplus.wales.nhs.uk
Nophakhun P, Yindee A, Amornpiyakij P, Hlekmon N,Tanavalee A. The efficiency of the patient care team on 3-day protocol for early ambulation after MIS-TKA.Journal of the Medical Association of Thailand.2012;95(4):537-43. (in Thai)
Eamchunprathip S, Sae-Sia W, Khuunpantavee N.Application of cold-press massage to exercise programmmes and its effects on patients recovery from total knee replacement surgery. Journal of Thailand Nursing and Midwifery Council. 2012;27(3):77-99.
(in Thai)
Charoencholvanich K. Perioperative and postoperative care for total knee arthroplasty. [Internet]. 2016 [cited2018 Sep12], Available from: http://www.rcostaoa2016.com
David BA, Cindy JA, Joshuel AP, Jonathan JC, Kevin MM, Neil AH. Reduced length of hospitalization in primary total knee arthroplasty patients using an updated enhanced recovery after orthopedic surgery (ERAS)pathway. J Arthroplasty. 2015;30(10):1705-9.
Painupong I, Sae-Sia W, Kupantawee N. Pain management programme and self-empowerment exercise activity: their impact on elderly total knee arthroplasty patients’ recovery. Journal of Thailand Nursing and Midwifery Council. 2015;30(1):99-111(In Thai)
American Academy of Orthopaedic Surgeons. OrthoInfo “Total knee replacement”. [Internet]. 2015 [cited 2019 Sep12], Available from: http://orthoinfo.aaos.org
Soukup, M. The center of advanced nursing practice evidence-based practice model. Nurs Clin N Am.2000;35:301-9.
Suebpanich A. Reduced post operative blood loss in total knee arthroplasty by using topicaltranexamic acid.Udonthani Hospital Medical Journal. 2016;24(1):94-101.
Wong J, Abrishami A El ,Beheiry H, Mahomed N, Davey JR, Gandhi R, Chung F. Topical application of tranexamic acid reduces post-operative blood loss in total knee arthroplasty. J Bone Joint Surgery 2010;92(15):2513-30.
Jiang H, Jian X, Shangguan Y, Qing J, Chen L. Effects of Enhanced Recovery After Surgery in Total Knee Arthroplasty for Patients Older Than 65 Years. Orthop Surg. 2019;11(2):229–35. Available from: https://doi.org/10.1111/os.12441
Thienpont A. Dose advanced cryotherapy reduce pain and narcotic consumption after knee arthroplasty. Clin Orthop
Relat Res. 2014;472(11): 3417-24.
The Royal College of Physicians of Thailand. Guide to develop clinical practice guidelines. Royal College Bulletin. 2001;18(6):36-47. (in Thai)