Orthopaedic Nursing最新文献

Since orthopaedic nurses often guide patients through pre- and postoperative periods, they play an integral role in fulfilling the new screening requirements released by the Centers for Medicare & Medicaid Services and the Joint Commission. This study aims to highlight measures taken by orthopaedic healthcare organizations to fulfill the 2024 Social Determinants of Health (SDOH) screening requirements. Survey questions were developed and distributed in collaboration with the National Association for Orthopaedic Nurses to assess organizational responses to the requirements. On average, participants rated their institutions' preparedness to screen for SDOH as 3.21, with 30% of respondents ranking their preparedness as a 1 or 2 (5 being "very prepared" and 1 being "not prepared at all"). Organizations should consider developing a written action plan to screen for and address SDOH. They should also consider integrating workflows into the electronic medical record to facilitate easier screening and increase communication between hospital administration and nursing staff surrounding these new requirements.

Background: Prosthetic joint infection (PJI) is a complication of total joint arthroplasty with a survival rate worse than some cancers.

Methods: A qualitative design, using descriptive phenomenology, was used to explore the lived experience of PJI. Twelve interviews were analyzed to report the essence of the phenomenon. A chart review was also conducted to assess surgical outcomes.

Results: Participants "made sense of" PJI through two themes: "The Nail in the Coffin" and "Struggle with Living." "The Nail in the Coffin" was represented by losses of independence, identity, and financial security. "Struggle with Living" was represented by pain, balance of burden, uncertainty, and emotional responses. Half of participants had poor outcomes including amputation and death.

Conclusion: The experience of PJI may be moderated by stage of life. Social support plays an important role, affecting both gratitude and guilt. Loss of independence and identity, pain, burden, and emotional responses are impactful experiences in PJI.

Adhesive capsulitis (AC) of the shoulder is a prevalent condition often characterized by a prolonged clinical course and significant patient morbidity, leading to a high socioeconomic burden. Despite numerous studies evaluating various treatment modalities, an optimized treatment algorithm remains elusive. Similarly, osteoarthritis (OA) of the shoulder presents a comparable clinical and an even higher socioeconomic impact. Advances in diagnostic imaging and short-term pain management options have not yielded effective long-term disease-modifying therapies. With the decreasing average age of patients suffering from glenohumeral OA, there is a growing interest in regenerative treatments aimed at alleviating symptoms, enhancing quality of life, and potentially postponing invasive surgical interventions. This paper provides an overview of the pathophysiology of both AC and glenohumeral osteoarthritis (GHOA), accompanied by a retrospective pilot case study demonstrating the efficacy of a novel orthobiologic approach known as the RELIEF® treatment. This innovative approach yielded promising short-term outcomes, including significantly improved multi-planar shoulder range of motion (ROM) and functional scores at six months post-treatment. The RELIEF® treatment involves diagnostic dynamic ultrasound to identify scarring or abnormalities in the fascia together with a hydrodissection technique using a combination of cryopreserved micronized human amniotic membrane suspension allograft (hAMA) and Isolyte crystalloid IV fluid. Under direct ultrasound guidance, local anesthetic (2% lidocaine with epinephrine 1:200,000) is utilized to perform multiple injections aimed at lysing fibrotic scar tissue and delivering the allograft to affected areas. Pre- and post-treatment assessments of ROM were conducted by a licensed physical therapist utilizing a goniometer. Measurements were taken at baseline (before treatment) and subsequently at two weeks, two months, four months, and six months post-treatment. Additionally, American Shoulder and Elbow Surgeons (ASES) scores and visual analog scale (VAS) pain ratings were recorded. An MRI of the shoulder (without contrast) was subsequently performed 4 months following the second RELIEF® treatment to evaluate for any radiographically significant changes and to correlate these findings with change in patient-reported symptoms and overall functional status.