ABSTRACT
Orthopaedic nursing often involves the use of equipment, and nurses may learn about the use of equipment on the job in informal ways. Staff may have difficulty attending in-services, may be off during quick informal in-services, or may not use equipment for a period of time after an in-service. Due to lack of knowledge, inconsistency in the implementation of ordered therapies resulting in poor outcomes, including pressure wounds and patient dissatisfaction, frequently occurs. Using continuous passive motion therapy as an example, an interactive educational approach to equipment training is presented. Such an approach helps formalize equipment training, provides a standard approach to implementing ordered therapy, provides references for staff after in-services, and improves patient outcomes.
Subject(s)
Education, Nursing, Continuing/organization & administration , Motion Therapy, Continuous Passive/nursing , Nursing Staff, Hospital/education , Orthopedic Nursing/education , Arthroplasty, Replacement, Knee/nursing , Clinical Competence , Humans , Motion Therapy, Continuous Passive/adverse effects , Motion Therapy, Continuous Passive/instrumentation , Orthopedic Nursing/methods , Outcome Assessment, Health Care , Patient Satisfaction , Postoperative Care/education , Postoperative Care/methods , Postoperative Care/nursing , Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , Total Quality Management , WashingtonABSTRACT
BACKGROUND: Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined. PURPOSE: The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain. METHODS: This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months. RESULTS: Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.
Subject(s)
Arthroplasty, Replacement, Knee/rehabilitation , Edema , Motion Therapy, Continuous Passive/methods , Surgery, Computer-Assisted/rehabilitation , Activities of Daily Living , Aged , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/methods , Edema/etiology , Female , Hematocrit , Humans , Length of Stay/statistics & numerical data , Male , Motion Therapy, Continuous Passive/nursing , Pain Measurement , Pain, Postoperative/diagnosis , Pain, Postoperative/etiology , Physical Therapy Modalities , Postoperative Care/methods , Prospective Studies , Range of Motion, Articular , Surgery, Computer-Assisted/adverse effects , Surgery, Computer-Assisted/methods , Treatment OutcomeABSTRACT
This article describes the nursing care for patients who are undergoing or have undergone a total knee replacement.
Subject(s)
Arthroplasty, Replacement, Knee/nursing , Perioperative Care/nursing , Arthrodesis , Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/psychology , Humans , Motion Therapy, Continuous Passive/nursing , Nurse's Role , Nursing Assessment/organization & administration , Orthopedic Nursing/organization & administration , Osteoarthritis, Knee/complications , Osteoarthritis, Knee/nursing , Osteoarthritis, Knee/surgery , Osteotomy , Pain/etiology , Patient Care Planning , Patient Education as Topic/organization & administration , Patient Selection , Perioperative Care/organization & administration , Perioperative Care/psychology , Perioperative Nursing/organization & administration , Quality of Life/psychologySubject(s)
Clinical Competence/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Motion Therapy, Continuous Passive/nursing , Nursing Staff, Hospital/legislation & jurisprudence , Postoperative Care/legislation & jurisprudence , Equipment Failure , Humans , Missouri , Motion Therapy, Continuous Passive/adverse effects , Peroneal Neuropathies/etiology , Postoperative Care/nursingABSTRACT
Acute respiratory distress syndrome (ARDS) is a fulminant form of respiratory failure, with diverse aetiology, despite technological advances in intensive care medicine; mortality rates remain 50-70%. Costs associated with the management of patients in intensive therapy unit (ITU) are very high; therefore, the requirement for those working in critical care to provide evidence-based practice is mandatory. One area of investigation is that kinetic therapy improves pulmonary complications in critically ill patients by positively influencing oxygenation and gaseous exchange. Whilst kinetic therapy does appear to be an effective therapy in ITU, there are inconsistencies in reported findings, and thus, clearly a need for further research into this innovative therapy to maximize its potential.
Subject(s)
Beds/standards , Motion Therapy, Continuous Passive/instrumentation , Respiratory Distress Syndrome/therapy , Critical Care/methods , Humans , Motion Therapy, Continuous Passive/nursing , Nurse's Role , Nursing Assessment , Oxygen Consumption , Posture , Respiratory Distress Syndrome/complications , Respiratory Distress Syndrome/metabolism , Respiratory Insufficiency/etiology , Rotation , Treatment OutcomeABSTRACT
Kinetic Therapy can improve outcomes for immobilized patients, but the treatment can be costly. Using a protocol designed by critical care nurses, nurses in your units can provide cost-effective Kinetic Therapy.
