Comprehensive Nursing Strategies to Reduce Hospital Stay for Total Knee Replacement Patients
Abstract
For total knee replacement patients, how to reduce hospital stay on the premise of high quality therapeutic effect is a most critical issue. Less hospital stay is benificial for not only decreasing unnecessary medical spending, but improving the therapies consequences as well. Thus, it is a key issue to alleviate the medical resources-strain problems and offer the patients more comfortable treatment conditions. In this work, researches of reducing hospital stay for total knee replacement patients over the last decade were investigated and comprehensive clinical nursing strategies were proposed. The proposed strategies are consisted of pre-operation education, physicotherapeutics during the surgery, multimodal pain management and discharge preparation. Advanced academic researches and clinical nursing experiences were summarized and comprehensive clinical nursing strategies for total knee replacement patients were demonstrated for reference.
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Regan E N, Phillips F, Magri T. Get a leg (or two) up on total knee arthroplasty. Nursing,2016, 2013, 43(7): 32-37.
Centers for Disease Control and Prevention (CDC). Public health and aging: projected prevalence of self-reported arthritis or chronic joint symptoms among persons aged> 65 years--United States, 2005-2030. MMWR. Morbidity and mortality weekly report, 2003, 52(21): 489.
Pine M, Fry D E, Jones B L, et al. Controlling costs without compromising quality: paying hospitals for total knee replacement. Medical care, 2010, 48(10): 862-868.
Hines P A, Kevin M Y. The changing reimbursement landscape: nurses' role in quality and operational excellence. Nursing Economics, 2009, 27(1): 7.
Tomek I M, Sabel A L, Froimson M I, et al. A collaborative of leading health systems finds wide variations in total knee replacement delivery and takes steps to improve value. Health Affairs, 2012: 10.1377.
Polit D F, Beck C T. Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins, 2008.
Duvall J J, Andrews D R. Using a structured review of the literature to identify key factors associated with the current nursing shortage. Journal of Professional Nursing, 2010, 26(5): 309-317.
Jones S, Alnaib M, Kokkinakis M, et al. Pre-operative patient education reduces length of stay after knee joint arthroplasty. The Annals of The Royal College of Surgeons of England, 2010, 93(1): 71-75.
Accelero Health Partners. Length of Stay Is Critical for Total Hip and Knee Replacement Cost of Care. Canonsburg, PA: Accelero Health Partners, 2014.
Ayalon O, Liu S, Flics S, et al. A multimodal clinical pathway can reduce length of stay after total knee arthroplasty. HSS journal, 2011, 7(1): 9-15.
Berger R A, Sanders S A, Thill E S, et al. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clinical Orthopaedics and Related Research®, 2009, 467(6): 1424-1430.
Cook J R, Warren M, Ganley K J, et al. A comprehensive joint replacement program for total knee arthroplasty: a descriptive study. BMC musculoskeletal disorders, 2008, 9(1): 1.
Hypnar L A, Anderson L. Attaining superior outcomes with joint replacement patients. Journal of Nursing Administration, 2001, 31(11): 544-549.
Ibrahim M S, Khan M A, Nizam I, et al. Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review. BMC medicine, 2013, 11(1): 1.
LIN P C, HUNG S H, WU H F, et al. The effects of a care map for total knee replacement patients. Journal of clinical nursing, 2011, 20(21‐22): 3119-3127.
Vanhaecht K, Bellemans J, De Witte K, et al. Does the organization of care processes affect outcomes in patients undergoing total joint replacement? . Journal of evaluation in clinical practice, 2010, 16(1): 121-128.
Lucas B. Total hip and total knee replacement: preoperative nursing management. British Journal of nursing, 2008, 17(21):1.
Maheshwari A V, Blum Y C, Shekhar L, et al. Multimodal pain management after total hip and knee arthroplasty at the Ranawat Orthopaedic Center. Clinical Orthopaedics and Related Research®, 2009, 467(6): 1418-1423.
Mayo Clinic Staff. Knee replacement definition[R].Rochester: Mayo Clinic, 2014.
McDonald S, Hetrick S E, Green S. Pre‐operative education for hip or knee replacement. The Cochrane Library, 2004.
McGinley A. Factors affecting length of stay following total knee replacement: a clinical practice audit. Journal of Orthopaedic Nursing, 2008, 12(3): 171-178.
Parisien K R, Valentine D, Hoffman V, et al. Enhancing the Patient's Experience Through the Total Joint Replacement Continuum of Care. Orthopaedic Nursing, 2012, 31(6): 322-325.
Shakespeare D, Kinzel V. Rehabilitation after total knee replacement. The Knee, 2005, 12(3): 185-189.
SooHoo N F, Lieberman J R, Farng E, et al. Development of quality of care indicators for patients undergoing total hip or total knee replacement. BMJ quality & safety, 2011, 20(2): 153-157.
Wheeler E C. The CNS's impact on process and outcome of patients with total knee replacement. Clinical Nurse Specialist, 2000, 14(4): 159-172.
Yoon R S, Nellans K W, Geller J A, et al. Patient education before hip or knee arthroplasty lowers length of stay. The Journal of arthroplasty, 2010, 25(4): 547-551.
Chan E Y, Fransen M, Parker D A, et al. Femoral nerve blocks for acute postoperative pain after knee replacement surgery. The Cochrane Library, 2014.
DOI: http://dx.doi.org/10.18686/jn.v9i1.162
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