THE DEVELOPMENT AND EVALUATION OF CLINICAL NURSING PRACTICE GUIDELINE FOR PROMOTING THE RECOVERY OF OLDER PATIENTS WITH TOTAL KNEE ARTHROPLASTY

Authors

  • วิลาวัณย์ นาคปลัด Faculty of Nursing, Songkla University
  • เนตรนภา คู่พันธวี Faculty of Nursing, Songkla University
  • หทัยรัตน์ แสงจันทร์ Faculty of Nursing, Songkla University

Keywords:

clinical nursing practice guideline, promoting recovery, older patients with total knee arthroplasty

Abstract

          This developmental study aimed to develop and evaluate a clinical nursing practice guideline (CNPG) for promoting the recovery of older patients with total knee arthroplasty. The CNPG development process was based on the principle and guideline of the National Health and Medical Research Council (NHMRC). The samples were 9 professional nurses and 19 older patients with total knee arthroplasty. The instruments consisted of clinical nursing practice guidelines (CNPG) for promoting the recovery of older patients in post-operative total knee arthroplasty, the manual for promoting the recovery of older patients with total knee arthroplasty with exercise logbook, and the process evaluation form of using CNPG. Data analysis used by frequency, percentage, mean, and standard deviation. The results of this study revealed that:

  1. The content of CNPG for promoting the recovery of older patients with total knee arthroplasty comprised 3 phases: (1) the preoperative phase, including educational information about osteoarthritis and total knee arthroplasty, preoperative preparation, pain management, and exercise for recovery, (2) the postoperative phase including pain management, covering for early ambulation, and (3) the discharge phase including continuing safety exercise.
  2. The process evaluation showed that all of nurses (100%) agreed over the guideline practicability and were satisfied with using this CNPG at a high level. Twelve percent suggested to improve the exercise record form.
  3. Clinical outcome showed that on the day before discharge, all of patients (100%) had a knee joint range of motion on flexion at an average of 91.68 ± 1.78 degrees. Then 2 weeks later, all of them (100%) had a knee joint range of motion on flexion at an average of 96.53 ± 5.76 degrees, and all of them (100%) were able to walk on a horizontal surface within 6 minutes in the target distance that is more than 20 meters, both on the day before discharge (M = 41.78, SD = 8.49) and 2 weeks after returning home (M = 54.69, SD = 1.56).

          The results of this study indicate that the CNPG can help nurses provide nursing care to promote the recovery of older patients with total knee arthroplasty and help older patients to recover after total knee arthroplasty. Therefore, this CNPG could be continuously practiced. However, applying to another context requires adaptation.

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References

American Academy of Orthopaedic Surgeons. (2013). Treatment of osteoarthritis of the knee: Evident- based guideline (2nd ed). Rosemont: Chicago. Retrieved from file:///C:/Users/USER/ Downloads/Documents/TreatmentofOsteoarthritisoftheKneeGuideline.pdf
American Academy of Orthopaedic Surgeons. (2015). Surgical management of osteoarthritis of the knee: Evident - based clinical practice guideline. Rosemont: Chicago. Retrieved from www.orthoguidelines.org
Baker, M., Preez, M., & Barlow, R. (2012). How to guide enhanced recovery after surgery (hip and knee joint arthroplasty). Retrieved from https://www.1000livesplus.wales.nhs.uk/opendoc/179596
Bunsanong, T., Sangchan, H., & Songwatana, P. (2011). Development and feasibility evaluation of clinical nursing practice guideline in caring for post-operative patients with epidural analgesia. Thai Journal of Nursing Council, 26(2), 115-125.
Cram, P., Lu, X., Kates, S., L., Singh, J., A., Li, Y., & Wolf, B. R. (2012). Total knee arthroplasty volume, utilization, and outcomes among medicare beneficiaries, 1991-2010. American Medical Association, 308(12), 1227-1236.
Department of Medical Services. (2013). Appraisal of guideline for research and evaluation II. Retrieve form https://www.agreetrust.org/wp-content/uploads/2013/09/Thai-AGREE-II.pdf
Evgeniadis, G., Beneka, A., Malliou, P., Mavromoustakos, S., & Godolias, G. (2008). Effects of pre-or postoperative therapeutic exercise on the quality of life, before and after total knee arthroplasty for osteoarthritis. Journal of Back & Musculoskeletal Rehabilitation, 21(3), 161-169.
Faculty of Physical Therapy, Mahidol University. (2014). Goniometer. Mahidol University, Nakhon Pathom.
Institute of Medical Research and Technology Assessment. (2556). Appraisal of guideline for research & evaluation II. Department of medical services, Ministry of public health.
Jirojanakul, P.(2005). Nursing research (3rd ed.). Bangkok: Media creation company.
Joanna Briggs Institute (JBI). (2014). New JBI levels of evidence. Retrieve September 3, 2017, from https://joannabriggs.org/assets/docs/approach/JBI-Levels-of-eviden ce_2014.pdf
Kangromklang, P. (2014). Effectiveness of care bundles implementation among elderly undergoing knee joint arthroplasty, private ward 10, Maharaj Nakorn Chiang Mai Hospital (Thesis master’s degree in nursing). Graduate School, Chiang Mai University.
Kanjanawattana, S. (2016). Osteoarthritis surgical offers increased access to treatment clinical practice guideline. Manager Online, Retrieved from https://www.manager.co.th/QOL/ViewNews.aspx?NewsID=9590000120824
Korean Knee Society. (2012). Guidelines for the management of postoperative pain after total
knee arthroplasty. Knee Surgery and Related Research, 24(4), 201-207.
Labraca, S. N., Castro-Sanchez, M. A., Mataran-Penarrocha, A. G., Morales, A. M., Sanchez-Joya, M. M., & Lorenzo, M. C. (2011). Benefits of starting rehabilitation within 24 hours of primary total knee arthroplasty: Randomized clinical trial. Clinical Rehabilitation, 25(6), 557-566. doi:10.1177/ 0269215510393759cre.sagepub.com
National Health and Medical Research Council (NHMRC). (2011). Procedures and requirements for meeting the 2011 NHMRC standard for clinical practice guidelines. Retrieved from https://www.nhmrc.gov.au/guidelines-publications/cp133-and-cp133a
Ninkanuwong, S. (2014). Osteoarthritis. In N. Kasitanon, P. Asawatanabodee, & P. Chiowchanwisawakit, (Eds.), Encore rheumatology (pp.286-310). Bangkok: City print.
Painupong, I. (2014). The effect of ice-pack management with self-efficacy enhancing exercise program on recovery outcomes in elderly patients after total knee arthroplasty (thesis of Master of Nursing Science (Adult Nursing)). Prince of Songkla University, Songkla.
Petterson, S. C., Mizner, R. L., Stevens, J. E., Raisis, L., Bodenstab, A., Newcomb, W., & Mackler, L. S. (2009). Improved function from progressive strengthening interventions after total knee arthroplasty: A randomized clinical trial with an imbedded prospective cohort. American College of Rheumatology, 61(2), 174–183. doi:10.1002/art.24167
Smith. R. M., Vos. J. D., Mokete. L., Zyl. A. V., Gelbart. B., Firer. P., & Fraser. R. (2016). A guideline to good practice in total knee replacement in South Africa 2016. Retrieved from https://www.saoa. org.za/files/applications/GuidelinesforBestPracticeinPrimaryKneeReplacemenSurgery.pdf
Soffin, E. M., & Yadeau, J. T. (2016). Enhanced recovery after surgery for primary hip and knee arthroplasty. British Journal of Anaesthesia, 117(S3), iii62–iii72. doi:10.1093/bja/aew362
Thailand Nursing and Midwifery Council. (2007). Nursing care for older patients with total knee arthroplasty, Clinical nursing practice guideline (pp. 237-247). Bangkok: Yellow E Business.
The Royal College of Orthopaedic Surgeons of Thailand, the Thai Rheumatology Association and the Royal College of Physiatrists of Thailand. (2011). Osteoarthritis of the knee: Evident-based clinical practice guideline. Retrieved from file:///C:/Users/USER/Download s/Documents/160610146554495425.pdf
Tiloksakulchai, F. (2009). Evidence-based nursing: Principle and method (5th ed.). Bangkok: Preone.
Wongratana, C. (2009). Techniques for statistics use for research (11th ed.) Bangkok: God of printing.
Yodrach, M., & Choowattanapakorn, T. (2013). The effects of a preparation program combined with a rubber chain exercise program on the functional capacity of elderly post total knee arthroplasty. Nursing journal of the ministry of public health. Retrieved from https://www.tci-thaijo.org/index.php/tnaph/article/view/16628/15047

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Published

2019-06-27

How to Cite

นาคปลัด ว., คู่พันธวี เ., & แสงจันทร์ ห. (2019). THE DEVELOPMENT AND EVALUATION OF CLINICAL NURSING PRACTICE GUIDELINE FOR PROMOTING THE RECOVERY OF OLDER PATIENTS WITH TOTAL KNEE ARTHROPLASTY. JOURNAL OF THE POLICE NURSES, 11(1), 73–85. Retrieved from https://he01.tci-thaijo.org/index.php/policenurse/article/view/167164

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Research Articles