Development of a Nursing Care Model for Elderly Patients with Undergoing Total Hip Arthroplasty at Nakhonphanom Hospital

Abstract

Hip replacement surgery for the elderly has increased, so the development of a nursing care model for elderly patients receiving total hip arthroplasty suitable for a particular context is necessary. This study aimed to develop and evaluate a nursing model for elderly patients undergoing hip replacement surgery at Nakhon Phanom Hospital from September 2022 to February 2024. The study was conducted in two phases: Phase 1 focused on developing the nursing model through situation analysis, model design, and pilot implementation involving 12 multidisciplinary healthcare professionals. Phase 2 involved evaluating the model’s effectiveness, using 30 elderly patients, 30 caregivers, and 30 nurses through interviews, medical record reviews, and satisfaction assessments. The developed nursing practice guideline consisted of four key phases: Preoperative Care, which focused on patient readiness, risk reduction, and enhanced recovery; Intraoperative Care, ensuring patient safety and minimizing complications; Postoperative Care, emphasizing complication monitoring, pain management, and rehabilitation; and Continuing Care, aimed at long-term recovery monitoring, reducing complications, and preventing hospital readmissions. The study results showed significant improvements, including reduced surgery waiting time, shorter hospital stays, and lower medical costs. Additionally, no hospital readmissions were recorded within 28 days, and patients demonstrated a statistically significant improvement in performing daily activities. Caregivers exhibited high levels of knowledge and caregiving competence, while all groups reported the highest level of satisfaction. In conclusion, this nursing model promotes structured, comprehensive, and continuous care for elderly patients receiving total hip arthroplasty. The case management nurses play a crucial role in improving clinical outcomes, fostering collaboration, and enhancing the long-term quality of care for elderly patients undergoing hip replacement surgery.