Outcome of Using Evidence-Based Clinical Nursing Practice Guideline for Hip Arthroplasty Patients: A Retrospective Comparative Study

Tuesday, 13 July 2010

Pensri Lausawatchaikul, RN, MNS
Nursing Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Learning Objective 1: The learner will be able to study outcome of using evidence-based clinical nursing practice guideline for hip arthroplasty patients.

Learning Objective 2: The learner will be able to learn about postoperative complication of hip arthroplasty patients and plan for prevention by developing clinical nursing practice guideline.

·   Purpose: This retrospective comparative study was performed to compare the outcomes of nursing care for hip arthroplasty patients on postoperative pain, number of days for first postoperative ambulation, LOS, postoperative complications and unplanned-readmission within 3 months after operation.
·   Methods:  The sample consisted of 80 hip arthroplasty patients who were admitted to orthopaedic wards, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.  The samples were divided into two groups, which consisted of 40 participants in each group.  The  group1 were participants who received usual nursing care.  Group2 were participants who received nursing care using evidence-based clinical nursing practice guideline for hip arthroplasty patients.    
·   Results: The characteristics of participants among two groups were not difference.  The majority was elderly, female and diagnosed fracture hip.  The mean age were 65.55 and 66.33 in group1 and group2, respectively.  The result  showed that postoperative pain score, number of days for first postoperative ambulation and LOS of  group1 slightly more than group2 but were not statistically significant difference.  Most postoperative complication was UTI, there were 5 patients in group1 and 2 patients in group2. They were elderly (age 70-100), had diagnosed UTI or Urinary retention prior operations. Acute confusional state, GI bleeding and Lung atelectasis were found 3, 2 and 1, respectively in each group. There was 1 patient in each group unplanned-readmission for UTI and AF (group1) and Bronchiectasis (group2). Both patients were elderly (age 70 and 84) and diagnosed SLE before surgery.  The most common side effect in this study was constipation, there were 35% in group1 and 47.50% in group2.
·    Conclusion: The result of this study is useful for improving clinical nursing practice guideline for prevention complications in the elderly patients with underlying diseases to enhance more effective nursing outcome in this area.