International Journal of Orthopaedic and Trauma Nursing最新文献_第3页

Improving external fixator pin site care through user involvement: A quality improvement project 通过用户参与改进外固定器针脚部位护理：质量改进项目。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-10-10 DOI: 10.1016/j.ijotn.2024.101139

Anette Wulff Christiansen , Trine Ahlman Petersen , Cellina Maj Eline Hedkjær , Julie Santy-Tomlinson , Charlotte Myhre Jensen

Introduction

External fixation is widely used in treating complex fractures and limb reconstruction. Pin site infections remain a significant complication, impacting on patients' physical and psychosocial wellbeing. This clinical improvement project at a University Hospital in Denmark aimed to enhance pin site care by involving patients and caregivers throughout the treatment pathway.

Background

At our hospital, approximately 55 trauma patients are annually treated with lower limb external fixators. Pin site care is crucial for preventing serious infections/osteomyelitis and involves collaboration between hospital and municipal caregivers. Traditional pin site care in our unit was complex and time-consuming, causing patient anxiety and frequent unplanned clinic visits.

Methods

Inspired by the Participatory Design research methodology, a quality improvement project was conducted in three phases: (1) identifying users’ needs, (2) developing solutions collaboratively, and (3) testing/evaluating these solutions. Iterative cycles of planning, acting, observing, and reflecting were employed, facilitating mutual learning among participants. Interviews with patients, families and healthcare professionals and field observations both at the hospital and in the municipality were conducted. Inspiration was sought from international literature.

Results

Phase 1 identified the need for improved education about infection recognition, a less painful and time-consuming dressing method, and an assessment tool for pin site infection. Phase 2 involved extensive user input to develop and implement a new dressing procedure using PolyMem™ along with an assessment tool. Phase 3 evaluated the new methods, revealing reduced patient pain, fewer clinic visits, and stable infection rates as well as less time-consuming pin site care.

Conclusion

The project successfully enhanced pin site care, involving users in developing a new care process, thus improving patient satisfaction and care efficiency.

Implications for future practice

Incorporating patient perspectives and collaborative methods can significantly improve clinical care pathways. Future efforts should focus on further integrating patient centered and participatory approaches in healthcare improvements.

导言：外固定被广泛用于治疗复杂骨折和肢体重建。针脚部位感染仍然是一个重要的并发症，影响着患者的身体和心理健康。丹麦一所大学医院开展的这一临床改进项目旨在通过让患者和护理人员参与整个治疗过程来加强针脚部位护理：背景：在我们医院，每年约有 55 名外伤患者接受下肢外固定器治疗。插针部位护理对于预防严重感染/骨髓炎至关重要，需要医院和市政护理人员通力合作。我们科室传统的插针部位护理既复杂又耗时，导致患者焦虑不安，经常出现计划外就诊：受参与式设计研究方法的启发，质量改进项目分三个阶段进行：(1) 确定用户需求，(2) 合作开发解决方案，(3) 测试/评估这些解决方案。项目采用了计划、行动、观察和反思的迭代循环，促进了参与者之间的相互学习。对病人、家属和医护人员进行了访谈，并在医院和市镇进行了实地观察。从国际文献中寻求灵感：结果：第一阶段发现需要改进有关感染识别的教育、减少痛苦和耗时的包扎方法以及针刺部位感染的评估工具。第 2 阶段涉及广泛的用户输入，以开发和实施使用 PolyMem™ 的新包扎程序和评估工具。第 3 阶段对新方法进行了评估，结果显示患者疼痛减轻，就诊次数减少，感染率稳定，针刺部位护理耗时减少：结论：该项目成功加强了针刺部位护理，让用户参与制定新的护理流程，从而提高了患者满意度和护理效率：对未来实践的启示：纳入患者观点和协作方法可显著改善临床护理路径。未来的工作重点应是进一步将以患者为中心和参与式方法融入医疗保健的改进中。

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引用次数: 0

Psychometric properties of Japanese version15D and cultural characteristics of quality of life undergoing patients with hip and knee arthroplasty 髋关节和膝关节置换术患者生活质量日文版 15D 的心理计量特性和文化特征。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-10-05 DOI: 10.1016/j.ijotn.2024.101138

Kanako Yakushiji , Satomi Tanaka , Harri Sintonen , Heidi Siira , Yuriko Matsunaga-Myoji , Yasuko Tabuchi , Pirjo Kaakinen , Maria Kääriäinen , Kimie Fujita

Background

Health-related quality of life (HRQoL) following total hip and knee arthroplasty (THA/TKA) may decline more in Asian countries due to lifestyle and housing factors compared with patients in Western countries.

Aims

To evaluate the psychometric properties of the Japanese version of 15D and clarify the characteristics of HRQoL in Japanese patients who underwent THA/TKA compared with Finnish patients.

Methods

This longitudinal study included 182 patients between 2019 and 2021. Patients' HRQoL was measured using the 15D preoperatively and 3 months postoperatively. Student's t-tests were used to compare lifestyles between Japan and Finland.

Results

The Japanese version of the 15D showed good internal consistency, reliability, construct validity, and responsiveness. Patients with many steps inside their house had worse HRQoL in the dimensions of mobility, distress, and vitality in Japan. There were significant differences in mobility, distress, vitality, and sexual activity dimensions between Japan and Finland 3 months postoperatively.

Conclusions

The lower HRQoL in Japan in the dimensions of mobility, distress, and vitality is likely due to Japan's traditional housing structure with many steps. Identifying differences in cultural and psychological characteristics, as well as by residential setting, will enable health care providers to help patients improve their HRQoL.

背景：目的：评估日文版15D的心理测量学特性，并明确与芬兰患者相比，接受全髋关节和膝关节置换术（THA/TKA）的日本患者的HRQoL特征：这项纵向研究包括2019年至2021年期间的182名患者。患者的 HRQoL 在术前和术后 3 个月使用 15D 进行测量。采用学生 t 检验比较日本和芬兰的生活方式：结果：日文版 15D 显示出良好的内部一致性、可靠性、结构效度和反应性。在日本，屋内台阶较多的患者在行动能力、痛苦和活力方面的 HRQoL 较差。日本和芬兰患者在术后3个月的活动能力、痛苦、活力和性活动方面存在明显差异：结论：日本人在行动能力、痛苦和活力方面的 HRQoL 较低，这可能是由于日本的传统住房结构有很多台阶。识别文化和心理特征以及居住环境的差异将有助于医疗服务提供者帮助患者改善其 HRQoL。

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引用次数: 0

The relationship of pain catastrophizing in principal caregivers of postoperative children with malignant bone tumors and children's kinesiophobia and pain perception: A cross-sectional survey 恶性骨肿瘤术后患儿主要照顾者的疼痛灾难化与患儿运动恐惧和疼痛感的关系：横断面调查

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-09-14 DOI: 10.1016/j.ijotn.2024.101137

Qian Yu , Fang Fang , Lan Chen , Qiuli Wang , Wei Dai

Objective

To examine the phenomenon of pain catastrophizing among the principal caregivers of postoperative children with malignant bone tumors and explore its impact on pain perception and kinesiophobia in children.

Design

A cross-sectional study design.

Methods

Using a cross-sectional study design, a questionnaire-based survey was conducted among 140 children with malignant bone tumors and their principal caregivers, who were admitted to a tertiary hospital in Shanghai from 2020 to 2023. Pearson's univariate and multiple regression analyses were conducted. The questionnaire included general data, the Parental Pain Catastrophizing Scale, the Short-Form McGill Pain Questionnaire, and the Tampa Scale of Kinesiophobia.

Results

The frequency of pain catastrophizing for the principal caregivers was 16.8%. The frequency of kinesiophobia in children was 93.1%. The level of pain catastrophizing was positively correlated with the level of kinesiophobia and pain perception (r = 0.556, 0.614, p < 0.05). Multiple logistic regression analysis showed that the level of pain catastrophizing in principal caregivers was an important factor of kinesiophobia in children (B = 0.370, Std. = 0.119, Wald = 9.687, Ex (P) = 1.448, p = 0.002). Multiple linear regression analysis showed that the incidence of pain catastrophizing and the level of kinesiophobia were important influencing factors in pain perception (p < 0.05), with R² = 0.272, adjusted R² = 0.249, F = 11.579, and p < 0.001.

Conclusions

The level of pain catastrophizing in the principal caregivers was an important factor in postoperative kinesiophobia and pain perception in children with a malignant bone tumor.

Practice implications

It is important to evaluate the patients' and their families' emotional changes and psychological needs during the perioperative period. Nurses play a crucial role in providing appropriate interventions for patients or families to reduce the negative pain experience and improve patients’ prognosis.

摘要] 目的研究恶性骨肿瘤术后患儿主要照顾者的疼痛灾难化现象，并探讨其对患儿疼痛知觉和运动恐惧的影响。采用皮尔逊单变量和多元回归分析。调查问卷包括一般数据、家长疼痛灾难化量表、短式麦吉尔疼痛问卷和坦帕运动恐惧症量表。儿童运动恐怖症的发生率为 93.1%。疼痛灾难化程度与运动恐怖症和疼痛知觉程度呈正相关（r = 0.556, 0.614, p <0.05）。多元逻辑回归分析表明，主要照顾者的疼痛灾难化水平是儿童运动恐惧的一个重要因素（B = 0.370，Std. = 0.119，Wald = 9.687，Ex (P) = 1.448，P = 0.002）。多元线性回归分析表明，疼痛灾难化的发生率和运动恐怖症的程度是疼痛知觉的重要影响因素（p < 0.05），R2 = 0.272，调整后 R2 = 0.249，F = 11.579，p < 0.001。结论主要护理人员的疼痛灾难化程度是影响恶性骨肿瘤患儿术后运动恐惧和疼痛知觉的重要因素。护士在为患者或家属提供适当的干预措施以减少负面疼痛体验和改善患者预后方面发挥着至关重要的作用。

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引用次数: 0

Current status of postoperative care for elderly osteoporotic fracture patients in Jiangsu Province, China: A multicenter cross-sectional study 中国江苏省老年骨质疏松性骨折患者术后护理现状：多中心横断面研究

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-09-11 DOI: 10.1016/j.ijotn.2024.101136

Mengting Sun , Xiafen Zhang , Jie Wang , Yang Hong , Ying Zhang , Jing Wang , Dongmei Xu , Xian Yu , Yingchun Zhang , Hongxia Zhu , Xiaolan Feng

Background

The postoperative care behavior of elderly osteoporotic fracture patients has a significant impact on their prognosis and rehabilitation; thus, it is critical to completely comprehend their current state of care before optimizing postoperative care strategies.

Aims

To determine the current status of postoperative care for elderly osteoporotic fracture patients in Jiangsu Province.

Methods

From October to December 2023, 669 elderly postoperative patients with osteoporotic fractures were recruited for a cross-sectional study via convenience sampling and a self-designed questionnaire from 21 hospitals in seven urban areas in Jiangsu Province.

Results

A total of 800 questionnaires were distributed, and 709 questionnaires were recovered, for a return rate of 88.6%. The postoperative support and care received by the patients were mostly by their children and spouses, and the postoperative health education knowledge received by the patients was mostly about fracture-related knowledge and precautions for the use of medications. Health education methods were mainly conducted by medical staff explanations and health brochures; only 45.3% of the patients were treated with anti-osteoporosis therapy.

Conclusions

The current status of postoperative care for osteoporotic fracture patients in Jiangsu Province varies somewhat according to geographic location, hospital level and other factors, with tertiary hospitals and more economically developed areas having relatively better care outcomes. For in-hospital care, it is necessary to improve the content and methods of in-hospital education. For out-of-hospital care, it is necessary to raise the level of awareness of anti-osteoporosis treatment and the prevention and treatment of re-fractures, and to improve hospital-community referral services.

背景老年骨质疏松性骨折患者的术后护理行为对其预后和康复有重要影响，因此，在优化术后护理策略之前，全面了解其护理现状至关重要。目的了解江苏省老年骨质疏松性骨折患者的术后护理现状。方法2023年10月至12月，通过便利抽样和自行设计的调查问卷，在江苏省7个市区的21家医院招募669例老年骨质疏松性骨折术后患者进行横断面研究。患者接受的术后支持和护理主要是其子女和配偶，接受的术后健康教育知识主要是骨折相关知识和用药注意事项。结论江苏省骨质疏松性骨折患者术后护理现状因地理位置、医院级别等因素存在一定差异，三级医院和经济较发达地区的护理效果相对较好。在院内护理方面，有必要改进院内教育的内容和方法。在院外护理方面，有必要提高抗骨质疏松症治疗和预防及治疗再次骨折的认识水平，并改善医院-社区转诊服务。

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引用次数: 0

LITERATURE REVIEWS – The effect of non-steroidal anti-inflammatory drugs (NSAIDs) on bone healing and tissue regeneration 文献综述 - 非甾体抗炎药（NSAIDs）对骨愈合和组织再生的影响

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-28 DOI: 10.1016/j.ijotn.2024.101126

Sonya Clarke, Carmen Queiros, Shareena Bibi Mohd Arif

引用次数: 0

Health literacy of older adults with musculoskeletal problems: A systematic review 有肌肉骨骼问题的老年人的健康素养：系统回顾

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-26 DOI: 10.1016/j.ijotn.2024.101127

Katerina Athanasopoulou , Manolis Mentis , Panagiota Vathi-Sarava , Georgios Nikolaou , Elias Panagiotopoulos

Introduction

People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems.

Methods

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria.

Results

The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status.

Discussion

It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.

导言：健康素养（HL）较差的人在日常生活中很难理解医疗信息，也很难参与与健康有关的决策，更难以遵守医疗指示。老龄化对肌肉骨骼系统的生理影响直接影响到与处理健康问题相关的技能。许多老年人的生活能力有限，这影响了他们全面参与护理的能力和健康状况。本研究旨在对已发表的有关低HL患病率及其对患有肌肉骨骼问题的老年人的健康状况影响的研究进行系统性回顾。在本综述的各项研究中，低 HL 百分比各不相同，从 14% 到 67% 不等。不过，在大多数研究中，HL 受限的患者约占参与者的 1/3。教育水平较低、性别为男性、年龄较大、收入较低、失业和原籍国不同的患者的 HL 水平较低。低 HL 还与较差的健康结果有关，尤其是对治疗的依从性、疼痛、功能和健康状况。讨论对这一患者群体进行旨在提高 HL 的教育干预具有重要意义，因为这将有助于增强这些患者的能力并促进其采取适当的健康行为。

{"title":"Health literacy of older adults with musculoskeletal problems: A systematic review","authors":"Katerina Athanasopoulou , Manolis Mentis , Panagiota Vathi-Sarava , Georgios Nikolaou , Elias Panagiotopoulos","doi":"10.1016/j.ijotn.2024.101127","DOIUrl":"10.1016/j.ijotn.2024.101127","url":null,"abstract":"<div><h3>Introduction</h3><p>People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems.</p></div><div><h3>Methods</h3><p>In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria.</p></div><div><h3>Results</h3><p>The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status.</p></div><div><h3>Discussion</h3><p>It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.</p></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101127"},"PeriodicalIF":1.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142095050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of fascia iliaca compartment block on postoperative delirium in elder adults undergoing hip surgery: A systematic review and meta-analysis of randomized controlled trials 髂骨筋膜室阻滞对接受髋关节手术的成年老年人术后谵妄的影响：随机对照试验的系统回顾和荟萃分析。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.ijotn.2024.101122

Ran Duan, Longlu Cao, Huanhuan Zhang, Pan Li, Xiaoqian Wu, Jianli Li

Objective

This meta-analysis aimed to evaluate whether fascia iliaca compartment block (FIB) could reduce the incidence of postoperative delirium (POD) in elderly patients undergoing hip surgery.

Methods

This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023490399). The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for randomized controlled trials (RCTs) till November 15, 2023. Review Manger 5.4 was used to analyze the data.

Results

A total of 10 RCTs with 930 elderly patients were included in this meta-analysis. This meta-analysis indicated that FIB could reduce the incidence of POD in elderly patients undergoing hip surgery without preoperative cognitive impairment (OR:0.46; 95%CI[0.22, 0.96], P = 0.04, I² = 0%). Subgroup analysis of the incidence of POD showed that elderly patients who received FIB treatment before entering the operating room had a lower risk of developing POD(OR:0.48; 95%CI[0.30, 0.76], P = 0.002, I² = 0%), and FIB could reduce the occurrence of POD in patients undergoing intravertebral anesthesia instead of general anesthesia (OR:0.37; 95%CI[0.20, 0.66], P﹤0.01, I² = 0%). Moreover, FIB could reduce the MMSE score on the first day after surgery (SMD:1.07; 95%CI[0.15, 1.99], P = 0.02, I² = 86%). In addition, FIB could reduce the pain score on the first and third day after surgery (SMD: -0.46; 95%CI[-0.74, -0.18], P = 0.001, I² = 43%; SMD: -0.62; 95%CI[-0.97, -0.26], P﹤0.001, I² = 58%), as well as after physical activity(SMD: -1.64; 95%CI[-3.00, -0.28], P = 0.02, I² = 83%).

Conclusion

FIB can reduce the incidence of POD in elderly patients undergoing hip surgery without pre-existing cognitive impairment. Additionally, it can lower the delirium scores and pain scores.

目的：本荟萃分析旨在评估髂筋膜室阻滞（FIB）能否降低接受髋关节手术的老年患者术后谵妄（POD）的发生率：该荟萃分析已在系统综述国际前瞻性注册中心（PROSPERO；CRD42023490399）注册。在PubMed、Embase、Web of Science和Cochrane Library数据库中检索了截至2023年11月15日的随机对照试验（RCT）。使用Review Manger 5.4分析数据：本次荟萃分析共纳入了 10 项随机对照试验，930 名老年患者。该荟萃分析表明，FIB 可降低接受髋关节手术且术前无认知障碍的老年患者的 POD 发生率（OR:0.46; 95%CI[0.22, 0.96], P = 0.04, I2 = 0%）。POD发生率的亚组分析显示，在进入手术室前接受FIB治疗的老年患者发生POD的风险较低（OR:0.48; 95%CI[0.30, 0.76], P = 0.002, I2 = 0%），FIB可减少接受椎管内麻醉而非全身麻醉患者的POD发生率（OR:0.37; 95%CI[0.20, 0.66], P﹤0.01, I2 = 0%）。此外，FIB 可以降低术后第一天的 MMSE 评分（SMD:1.07; 95%CI[0.15, 1.99], P = 0.02, I2 = 86%）。此外，FIB还能降低术后第一天和第三天的疼痛评分（SMD：-0.46；95%CI[-0.74，-0.18]，P=0.001，I2=43%；SMD：-0.62；95%CI[-0.97，-0.26]，P﹤0.001，I2=58%）以及体力活动后的疼痛评分（SMD：-1.64；95%CI[-3.00，-0.28]，P=0.02，I2=83%）：结论：FIB 可以降低接受髋关节手术且无认知障碍的老年患者的 POD 发生率。结论：FIB 可以降低无认知障碍的老年髋关节手术患者的 POD 发生率，还可以降低谵妄评分和疼痛评分。

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引用次数: 0

Considerations for managing pain in the older adult 控制老年人疼痛的注意事项。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.ijotn.2024.101117

引用次数: 0

Assessment of rehabilitation nurses' knowledge and results of nurse educational programme (C2F) regarding osteoporosis and fragility fractures 评估康复护士对骨质疏松症和脆性骨折的认识以及护士教育计划（C2F）的成果

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.ijotn.2024.101120

Georgina Pimentel , Arménio Cruz , Cristina Lavareda Baixinho , Maria Loureiro , Sílvia Fernandes , Ricardo J.O. Ferreira , Andréa Marques

Background

Providing adequate care for the person with a fragility fracture is essential to prevent recurrences. A key strategy involves training by improving nursing care in the fields of osteoporosis and fragility fractures. However, in Portugal, there is no report on the level of knowledge of nurses, nor experimental studies on how to improve it.

Objective

The study aimed to assess the knowledge of Rehabilitation Nurses in Portugal on osteoporosis and fragility fractures. Additionally, it sought to evaluate the impact of a specific educational programme on nurses' knowledge.

Methods

In Phase I, a cross-sectional study involved 452 participants, utilizing a 26-question knowledge test. In Phase II, a quasi-experimental study included 42 nurses from 28 hospitals, subjected to a 30-h hybrid educational programme. The program comprised 9 online (2 h 30 min each) and 2 live sessions, covering assessment, pharmacological and non-pharmacological treatment, monitoring, project planning, consultations, and outcome indicators measurement. A before-and-after programme knowledge test was administered.

Results

Phase I revealed an average knowledge score of 69.6%. In Phase II, there was a significant improvement with programme (70.4% vs. 85.8%, p < 0.01). Specialized nurses performed better than non-specialized nurses (80% vs. 75%, p = 0.011), and those from orthopaedic services showed the greatest improvement (92% vs. 83%, p = 0.014).

Conclusions

Rehabilitation Nurses in Portugal have room to improve their knowledge of osteoporosis and fragility fractures. The hybrid educational programme proved effective in improving nurses' knowledge, especially among specialist and orthopaedic service nurses. We hope that this knowledge can be translated into continuous improvement in healthcare provision.

背景为脆性骨折患者提供充分的护理对预防复发至关重要。一项重要的策略是通过改善骨质疏松症和脆性骨折领域的护理来进行培训。本研究旨在评估葡萄牙康复护士对骨质疏松症和脆性骨折的了解程度。此外，该研究还试图评估特定教育计划对护士知识的影响。方法在第一阶段，一项横断面研究涉及 452 名参与者，采用了 26 个问题的知识测试。第二阶段是一项准实验研究，共有来自 28 家医院的 42 名护士参加了为期 30 小时的混合教育课程。课程包括 9 节在线课程（每节 2 小时 30 分钟）和 2 节现场课程，内容包括评估、药物和非药物治疗、监测、项目规划、咨询和结果指标测量。第一阶段的平均知识得分率为 69.6%。在第二阶段，计划实施后的得分有了显著提高（70.4% 对 85.8%，p < 0.01）。专科护士的表现优于非专科护士（80% 对 75%，p = 0.011），骨科护士的进步最大（92% 对 83%，p = 0.014）。事实证明，混合教育计划能有效提高护士的知识水平，尤其是专科护士和骨科护士。我们希望这些知识能够转化为医疗服务的持续改进。

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引用次数: 0

Enhancing orthopedic care: The impact of introducing nurse practitioners 加强骨科护理：引入执业护士的影响。

IF 1.5 Q3 NURSING

International Journal of Orthopaedic and Trauma Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.ijotn.2024.101123

Sarah Crowe , Brittany G. Spence , Pamela Colley

Introduction

Orthopedic surgery constitutes a significant portion of surgical interventions globally, driven by aging populations (Spence et al., 2019). Nurse practitioners (NPs) have emerged as essential team members in orthopedic surgery, offering expertise and advanced training.

Purpose

This paper describes a practice development initiative that saw the integration of NPs to the orthopedic team to provide postoperative care to patients undergoing hip and knee arthroplasty procedures.

Methods

Aggregate data was collected from electronic health records and from online surveys.

Results

Using descriptive and inferential statistics our data analysis revealed significant improvements post-NP implementation. Monthly surgeries increased by 41.6%, indicating enhanced access to care. The average length of stay decreased statistically for both hip and knee surgeries (p < 0.001), resulting in substantial cost savings and streamlined resource utilization. The readmission rate post-discharge also decreased by 41.6%, reflecting improved continuity of care facilitated by NPs. Surveys among healthcare staff demonstrated positive feedback regarding NP integration, highlighting improved accessibility, bed utilization, and timely treatment of medical issues.

Conclusion

This study underscores the multifaceted benefits of NP integration in orthopedic care, including enhanced patient outcomes, improved healthcare efficiency, and positive impacts on the healthcare team dynamics. Continued investment in NP programs in orthopedic settings is crucial for further optimizing care delivery and patient outcomes. Advocating for the expansion of the NP role in orthopedic surgery will contribute to elevating the standard of care in this specialty.

导言：在人口老龄化的推动下，骨科手术在全球外科干预中占了很大一部分（Spence 等人，2019 年）。目的：本文介绍了一项实践发展计划，该计划将护士纳入骨科团队，为接受髋关节和膝关节置换术的患者提供术后护理：方法：从电子健康记录和在线调查中收集汇总数据：通过描述性和推论性统计，我们的数据分析显示，实施 NP 后情况有了显著改善。月手术量增加了 41.6%，这表明医疗服务的可及性得到了提高。据统计，髋关节和膝关节手术的平均住院时间均有所缩短（p 结论：这项研究强调了实施 NP 所带来的多方面影响：这项研究强调了将 NP 整合到骨科护理中的多方面益处，包括改善患者预后、提高医疗保健效率以及对医疗保健团队动态产生积极影响。继续投资骨科领域的 NP 项目对于进一步优化护理服务和患者疗效至关重要。倡导扩大 NP 在骨科手术中的作用将有助于提高该专业的护理标准。

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引用次数: 0