Amani Allen, Mary Ann Francisco, Jessica Jatis, Yonous Turner, Rachel Nordgren, Daniel Rubin, Megan Huisingh-Scheetz, Darren S Bryan, Jessica Donington, Mark K Ferguson, Lauren J Gleason, Maria Lucia Madariaga
{"title":"实施虚弱特异性术后医嘱集，改善虚弱成人择期胸外科手术的术后疗效。","authors":"Amani Allen, Mary Ann Francisco, Jessica Jatis, Yonous Turner, Rachel Nordgren, Daniel Rubin, Megan Huisingh-Scheetz, Darren S Bryan, Jessica Donington, Mark K Ferguson, Lauren J Gleason, Maria Lucia Madariaga","doi":"10.1097/NCQ.0000000000000784","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Frailty is independently associated with adverse patient outcomes after surgery. The current standards of postoperative care rarely consider frailty status.</p><p><strong>Local problem: </strong>There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.</p><p><strong>Methods: </strong>A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.</p><p><strong>Interventions: </strong>A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.</p><p><strong>Results: </strong>There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).</p><p><strong>Conclusions: </strong>Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.</p>","PeriodicalId":16931,"journal":{"name":"Journal of nursing care quality","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Implementing a Frailty-Specific Postoperative Order Set to Improve Postoperative Outcomes in Frail Adults After Elective Thoracic Surgery.\",\"authors\":\"Amani Allen, Mary Ann Francisco, Jessica Jatis, Yonous Turner, Rachel Nordgren, Daniel Rubin, Megan Huisingh-Scheetz, Darren S Bryan, Jessica Donington, Mark K Ferguson, Lauren J Gleason, Maria Lucia Madariaga\",\"doi\":\"10.1097/NCQ.0000000000000784\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Frailty is independently associated with adverse patient outcomes after surgery. The current standards of postoperative care rarely consider frailty status.</p><p><strong>Local problem: </strong>There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.</p><p><strong>Methods: </strong>A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.</p><p><strong>Interventions: </strong>A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.</p><p><strong>Results: </strong>There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).</p><p><strong>Conclusions: </strong>Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.</p>\",\"PeriodicalId\":16931,\"journal\":{\"name\":\"Journal of nursing care quality\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of nursing care quality\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/NCQ.0000000000000784\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of nursing care quality","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/NCQ.0000000000000784","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
Implementing a Frailty-Specific Postoperative Order Set to Improve Postoperative Outcomes in Frail Adults After Elective Thoracic Surgery.
Background: Frailty is independently associated with adverse patient outcomes after surgery. The current standards of postoperative care rarely consider frailty status.
Local problem: There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.
Methods: A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.
Interventions: A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.
Results: There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).
Conclusions: Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.
期刊介绍：
Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.
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