Application of project improvement in early out-of-bed activity of patients after total knee arthroplasty
10.3760/cma.j.cn115682-20200222-00954
- VernacularTitle:专案改善在全膝关节置换患者术后早期下床活动中的应用
- Author:
Ping LI
1
;
Juan SHAO
;
Li ZHANG
;
Ling HUANG
;
Fengjuan LU
Author Information
1. 山东第一医科大学附属省立医院骨关节科，济南 250021
- Keywords:
Total knee arthroplasty;
Early out-of-bed;
Knee joint function;
Project improvement
- From:
Chinese Journal of Modern Nursing
2020;26(26):3604-3609
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of project improvement on improving early out-of-bed activity of patients after total knee arthroplasty (TKA) .Methods:From June 2018 to March 2019, a project improvement team was established in Department of Joint Surgery of a ClassⅢ Grade A hospital in Shandong province. The 56 patients undergoing TKA before the implementation of the project improvement were set as the pre-improvement group, and 58 patients undergoing TKA after the implementation of the project improvement were set as the post-improvement group. Based on the analysis of project improvement methods, the improvement was made from the following aspects, including formulating and implementing the standardized plan of early postoperative out-of-bed activity plan for TKA patients, perfecting management strategy of cluster pain and perfecting the implementation standard of drainage tube management in the department. The incidence of postoperative complications, knee joint function recovery and postoperative hospital stay were compared between the two groups.Results:After the implementation of project improvement, out-of-bed activity time for the first time was shortened to (21.49±4.94) h, the time for postoperative straight leg elevation was shortened to (32.10±11.48) h, time for 90°knee flexion was shortened to (23.08±5.93) h, and the postoperative hospital stay was shortened to (4.12±1.03) d. The differences were statistically significant ( t=-26.06, -5.37, -6.88, -10.37; P<0.01) . There was no statistically significant difference in the incidence of incision bleeding before and after the implementation of the project improvement ( P>0.05) . The incidence of postoperative constipation decreased from 17.9% (10/56) before improvement to 3.4% (2/58) , and the postoperative erection intolerance increased from 5.4% (3/56) before improvement to 20.7% (12/58) . The differences were statistically significant (χ 2=6.28, 4.36; P<0.05) . Conclusions:The implementation of the project improvement can shorten early out-of-bed activity of patients after TKA, reduce the incidence of postoperative constipation, accelerate the rehabilitation process of knee function, and shorten the postoperative hospital stay.
