RESUMO
The use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital was analysed. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. We anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
Assuntos
Artroplastia do Joelho , Transfusão de Sangue Autóloga/métodos , Drenagem/métodos , Procedimentos Cirúrgicos Eletivos , Benchmarking , Transfusão de Sangue Autóloga/economia , Transfusão de Sangue Autóloga/enfermagem , Distribuição de Qui-Quadrado , Redução de Custos , Análise Custo-Benefício , Drenagem/economia , Drenagem/enfermagem , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Nova Zelândia , Auditoria de Enfermagem , Pesquisa em Avaliação de Enfermagem , Satisfação do Paciente , Cuidados Pós-Operatórios/economia , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/enfermagem , Estudos Retrospectivos , Segurança , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this study was to describe the experience of adults with osteoarthritis who had undergone a total knee joint arthroplasty. METHOD: Grounded theory qualitative methodology was applied. SAMPLE: Purposive and theoretical sample of nine participants. FINDINGS: In managing the experience of total knee joint arthroplasty, participants expressed the basic psychosocial process, "Getting back to the future." There were three main categories identified within this process, "enduring," "thinking twice," and "keeping faith." "Enduring" conceptualized the way the participants lived their daily lives. "Thinking twice" captured the participants' processes of adaptation and problem solving. "Keeping faith" was the combination of determination, trust, and optimism that sustained participants as they progressed through the total knee joint arthroplasty experience to rehabilitation. CONCLUSION: The study provides a grounded theory of the participants' perspectives of undergoing total knee joint arthroplasty, making the process more visible for those involved in their care. Prehabilitation, postoperative care, and discharge planning can facilitate the patients' optimism and motivation to self-help. Further research to explore the process from the perspective of patients with rheumatoid arthritis and patients who have complications is recommended.
