Effects of Clinical Practice Guideline Implementation for Patients Undergoing Total Knee Arthroplasty

Authors

  • Nutthakrit Swangnade
  • Varin Binhosen
  • Nam-oy Pakdevong

Keywords:

Clinical practice guideline, total knee arthroplasty

Abstract

Persons with knee osteoarthritis undergoing total knee arthroplasty requires an evidenced-based clinical practice guideline for nursing care from admission to discharge from the hospital for better outcomes. This one group posttest only design aimed to investigate the effects of a clinical practice guideline for caring of persons undergoing total knee arthroplasty. The nursing role effectiveness model of Irvine, et.al (2003) was used as a conceptual framework. The purposive sample were 20 men and women who were admitted for total knee arthroplasty. The clinical practice guideline for caring persons undergoing total knee arthroplasty was employed by 13 trained professional nurses. Data were collected by using the recording form of demographic data, pain score assessment and pain management, range of knee motion, length of stay, and patients' satisfaction questionnaire. Descriptive statistics including frequency, percentage, mean, standard deviation and inferential statistic; one sample t-test were used for data analysis. The findings revealed that the clinical practice guideline's had effect on patients outcomes and hospital outcomes were statistically significant : mean score ofpain less than 3 during 24, 48, and 72 hours post operation [2.31, 2.42, and 2.07 respectively] (p < .01, p < .01, and p < .001 respectively), mean range of knee motion (more than 100 degree on day of discharge), mean length of stay [mean score 6.55 days , less than 9 days] (p < .001, and p < .001respectively). Moreover patients' satisfaction scores were significant statistically higher than 80% (p < .001). The Clinical practice guideline for caring persons undergoing total knee arthroplasty was recommended for further use to improve quality of nursing care.

References

Agency for Clinical Innovation [ACI].(2012).

Evidence review preoperative, preoperative and

pooperative care of elective primary total hip

and knee replacement.ACI Musculoskeletal

Network, 20 (12),3-50.

American Academy of Orthopaedic Surgeons [AAOS].

(2014). Annual incidence of common musculoskeletal

procedures and treatment. Department of

research & scientific Affairs, 42(2), 3-5.

American Academy of Orthopaedic Surgeons [AAOS].

(2015). Surgical management of osteoarthritis

of the knee: Evidence-based clinical practice

guideline. Adopted by the American academy of

orthopaedicsurgeouns board of directors.12,

-458.

D’Apuzzo, M. R., Novicoff, W. M. &Browne, J. A.

(2015). The john insall award: Morbid obesity

independently impacts complications, mortality

and resource use after TKA.Clinicalorthopedics

and related research, 473, 57-63.

Department of Mental health, Department of Medical

services & Department of Thai traditional and

alternative medicine ministry of public health.

(2012). Guide to the care of patients with

alzheimer's disease For staff in sub district Health

Promotion Hospital. [In Thai] Retrieved fromhttp:/

/mhtech.dmh.moph.go.th/ver6/book/MD000

Eamchunprathip, S., Sae-Sia., W. &Khupantavee, N.

(2012). Application of cold-press massage to

exercise programmes and its effects on patients'

recovery from total knee replacement rurgery.

Thai Journal of Nursing Council, 27(3), 77-90.

[In Thai]

Irvine, D., Sidani, S. & Mcgillis Hall, L. M. (2003).

The Nursing Role Effectiveness.In D.M. D. (Ed.),

Nursing-sensitive Outcome State of the science

(pp. 13-15). Unite States of American: Courier

Stoughton.

Kangromkang, P. (2014). Effectiveness of care bundles

implementation among elderly undergoing knee

joint arthroplasty, private ward 10, Maharaj

Nakorn Chiang Mai Hospital, (Master's thesis).

[In Thai]Retrieved from http://cmuir.cmu.ac.th/

jspui/handle/6653943832/45886

Kanitnet, S. & Thammachot, N. (2014).pain control in

total knee arthroplasty.Hip& Knee today, 10,

-20. [In Thai]Retrieved fromhttp://citeseerx.ist.

psu.edu/viewdoc/download?doi=10.1.1.690.1259

& rep=rep1& type=pdf

Korean Knee Society[KKS]. (2012). Guidelines for the

management of postoperative pain after total

kneearthroplasty.(Knee surgery & related

research), 24,201-207.

Kruearat, R., &Sringamchoi, P. (2013).The outcome of

total knee replacement patient care program

of 60-bed special ward in Si SaKet Hospital.

Journal of Health Science, 22(5), 899-906.

[In Thai]

Kurtz, S. M., Ong, K. L., Lau, E., Bozic, K. J., Berry,

D. & Parvizi, J. (2010).Prosthetic joint infection

risk after TKA in the medicare population.

Clinicalorthopedics and related research, 468,

-56.

Lausawatchaikul, P., Chatriyanuyok, B., & Warapapong,

(2012). Successful implementation of clinical

pathway for total knee arthroplasty patients in

clinical practice.Ramathibodi Nursing Journal,

(2), 153-165. [In Thai]

Maempel, J. F., Riddoch, F., Calleja, N. & Brenkel, I.

J.(2015).Longer hospital stay, more complications,

and increased mortality but substantially

improved function after knee replacement in older

patients.Acta orthopaedica, 86(4), 451-456.

National Health Security Office. (2017). Practice

guidelinesfor osteoarthritis of the knee

decentralize The district helps patients access

treatment. [In Thai] Retrieved from. https://www.

nhso.go.th/frontend/NewsInformation Detail.

aspx?newsid =MjA0OQ==

Parker, R.J.(2011).Evidence-based practice caring for

a patient undergoing total knee arthroplasty.

Orthopaedic nursing, 30(1), 4-8

Teekhasaenee, C. & Kosuwon, W. (2014).Comparison

between 1-hour clamping drainage and nonclamping

drainage after total knee arthroplasty.

Srinagarind Medical Journal,29(4), 77-90.

[In Thai]

Thai Association for the Study of Pain.(2011). The

royal college of anesthesiologists of Thailand.

Clinical guidance for acute pain management,1,

-46. [In Thai]

The royal college of orthopedic surgeons of Thailand.

(2011).Guideline for the treatment of osteoarthritis

of knee 2011.[In Thai] Retrieved from https://

www.chiangmaihealth.go.th/cmpho_web/

document/160610146554495425.pdf

Thienpont,.(2014).Does advanced cryotherapy reduce

pain and narcotic consumption after knee

arthroplasty. Clinical orthopedics and related

research,472 (11), 3417- 3424.

Waragulnukroh,W,Payakkaraung, S,Achawakulthep.,

W. &Bunprakong, L. (2012). Pain experiencein

patients undergoing total kneereplacement.

Journal of Nursing Science, 29(3), 74-82

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Published

2019-05-29

How to Cite

Swangnade, N. ., Binhosen, V., & Pakdevong, N.- oy. (2019). Effects of Clinical Practice Guideline Implementation for Patients Undergoing Total Knee Arthroplasty. NU Journal of Nursing and Health Sciences, 13(2), 101–112. Retrieved from https://he01.tci-thaijo.org/index.php/NurseNu/article/view/176925