Embedding evidence of early postoperative off-bed activities and rehabilitation in a real clinical setting in China: an interrupted time-series study

Abstract

Background Patients should be encouraged to mobilize with 24 h of caesarean section. However, the time of the first off-bed activity after surgery is usually 24 ~ 48 h in China. Due to the lack of knowledge of early off-bed activities, lack of attention to medical pain, and the absence of systematic evidence for the clinical transformation process. the aim of this study was showed that the application of evidence needs to be embedding in the real setting to construct the localization plan and achieve the effective result. Methods To establish evidence of the benefits of early postoperative off-bed activities on patients’ well-being based on a literature review. An interrupted time series analysis was used to evaluate the effectiveness of the intervention. The first and third periods were both five months (from February 1st, 2019 to January 31st, 2020), with a two-month interrupted time (from July 1st, 2019 to August 31st, 2019). Results Eight clinical practices were retrieved from the literature and incorporated into the intervention. A total of 465 patients were included: 226 patients before and 239 patients after implementing the intervention. The average onset time of postoperative off-bed activities was significantly earlier after the intervention than before the intervention (20.01 vs. 31.89 h after the operation, P < 0.001). The 24-h off-bed rate increased from 30.94% before to 91.21% after the intervention (P < 0.001). The average pain score of patients decreased from 5.23 points before to 3.82 points after the intervention (P = 0.032). The average postoperative hospital stay was shortened from 5.06 days before to 3.51 days after the intervention (P < 0.001). In addition, the incidence rates of postoperative ileus (POI) and infection decreased from 5.38% and 2.65% before to 1.67% and 0.84% after the intervention, respectively (P < 0.001). Conclusions We established an evidence-based nursing intervention. Evaluation of the effect of evidence-based practices should be considered in the clinical setting and include preoperative health education, effective analgesia management, and safety management.

Upaya Peningkatan Pengetahuan Ibu Tentang Pentingnya Mobilisasi Dini Ibu Nifas

“…Mobilisasi dini dilakukan secara bertahap, yakni setelah operasi, pada 6 jam pertama ibu paska operasi seksio sesarea harus tirah baring dulu (Y. Chen, Wan, Zhu, Su, & Mei, 2022). Mobilisasi Kontribusi,Vol.4 No.2 Mei 2024 ISSN: 2747-2027 (Print) / 2747-2035 (Online) DOI: https://doi.org/10.53624/kontribusi.v4i2.364 dini yang bisa dilakukan adalah menggerakkan lengan, tangan, menggerakkan ujung jari kaki dan memutar pergelangan kaki, mengangkat tumit, menegangkan otot betis serta menekuk dan menggeser kaki.…”

Effect of humanised care on the surgical site wound infection after caesarean: A meta‐analysis

“…Wound infection has been linked to poor prognosis and increased costs of treatment, as well as infectious diseases and even life‐threatening organ failure in severe cases 6 . Caesarean section is a traumatic approach for foetal delivery, and the effective implementation of clinical care plays an pivotal role in the postoperative recovery of the mother 7 . The incidence of complications after caesarean section was found to be considerably higher than that following natural delivery, and thus nursing care is more demanding 8,9 .…”

“… 6 Caesarean section is a traumatic approach for foetal delivery, and the effective implementation of clinical care plays an pivotal role in the postoperative recovery of the mother. 7 The incidence of complications after caesarean section was found to be considerably higher than that following natural delivery, and thus nursing care is more demanding. 8 , 9 Traditional routine care primarily involves the mechanical implementation of medical advice, often ignoring the psychological changes experienced by the mother, resulting in poor nursing results.…”