Developmental and Evaluation of the Use of Nursing Practice Guideline in Patients with Total Knee Arthroplasty

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Maneewan Homepan
Suchira Chaiviboontham
Nirobol Kanogsunthorntrat


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


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Homepan M, Chaiviboontham S, Kanogsunthorntrat N. Developmental and Evaluation of the Use of Nursing Practice Guideline in Patients with Total Knee Arthroplasty. Rama Nurs J [Internet]. 2022 Apr. 22 [cited 2022 Aug. 8];28(1):75-92. Available from:


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