TY - JOUR
T1 - Nursing in fast-track total hip and knee arthroplasty
T2 - A retrospective study
AU - Specht, Kirsten
AU - Kjaersgaard-Andersen, Per
AU - Kehlet, Henrik
AU - Pedersen, Birthe D
N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - AIM: To describe the increased activity in total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2002 to 2012 in a single orthopaedic department, the organisation of fast-track and its consequences for nursing care.METHODS: Retrospective, descriptive design. Data collection; from the hospital administrative database, local descriptions of fast-track, personal contact and discussion with staff.RESULTS: The number of operations increased threefold from 351 operations in 2002 to 1024 operations in 2012. In 2012, THA/TKA patients had a postoperative mean LOS of 2.6/2.8 days. Nurses had gained tasks from surgeons and physiotherapists and thus gained more responsibility, for example, for pain management and mobilisation. Staffing levels in the ward in 2002 and 2012 were almost unchanged; 16.0 and 15.8 respectively. Nurses were undertaking more complicated tasks.CONCLUSION: Nursing care must still focus on the individual patient. Nurses need to have enough education to manage the complex tasks and increased responsibility. To prevent undesirable outcomes in the future, there is a need to pay attention to the nursing quality in balance with the nursing budget. It may, therefore, be considered a worthwhile investment to employ expert/highly qualified professional nurses in fast-track THA and TKA units.
AB - AIM: To describe the increased activity in total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2002 to 2012 in a single orthopaedic department, the organisation of fast-track and its consequences for nursing care.METHODS: Retrospective, descriptive design. Data collection; from the hospital administrative database, local descriptions of fast-track, personal contact and discussion with staff.RESULTS: The number of operations increased threefold from 351 operations in 2002 to 1024 operations in 2012. In 2012, THA/TKA patients had a postoperative mean LOS of 2.6/2.8 days. Nurses had gained tasks from surgeons and physiotherapists and thus gained more responsibility, for example, for pain management and mobilisation. Staffing levels in the ward in 2002 and 2012 were almost unchanged; 16.0 and 15.8 respectively. Nurses were undertaking more complicated tasks.CONCLUSION: Nursing care must still focus on the individual patient. Nurses need to have enough education to manage the complex tasks and increased responsibility. To prevent undesirable outcomes in the future, there is a need to pay attention to the nursing quality in balance with the nursing budget. It may, therefore, be considered a worthwhile investment to employ expert/highly qualified professional nurses in fast-track THA and TKA units.
KW - Arthroplasty, Replacement, Hip
KW - Arthroplasty, Replacement, Knee
KW - Humans
KW - Length of Stay
KW - Nursing Care
KW - Nursing Staff, Hospital
KW - Pain, Postoperative
KW - Retrospective Studies
U2 - 10.1016/j.ijotn.2014.10.001
DO - 10.1016/j.ijotn.2014.10.001
M3 - Journal article
C2 - 26122593
SN - 1878-1241
VL - 19
SP - 121
EP - 130
JO - International Journal of Orthopaedic and Trauma Nursing
JF - International Journal of Orthopaedic and Trauma Nursing
IS - 3
ER -