Patient experience in fast‐track hip and knee arthroplasty – a qualitative study

Specht, Kirsten; Kjærsgaard‐Andersen, Per; Pedersen, Birthe D.

doi:10.1111/jocn.13121

Cited by 59 publications

(151 citation statements)

References 20 publications

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“…In addition, patients sometimes have to wait to be treated for days or even months and are not treated in a timely manner due to limited hospital resources [3]. To appropriate allocate resources, decreasing the length of hospital stay (LOS) is an ideal course of action [4].…”

Section: Introductionmentioning

confidence: 99%

“…In recent decades, there has been a considerable amount of progress in reducing the LOS [5] because many potential factors for prolonged LOS have been studied, including age, sex, comorbidities, weekend admission, the American Society of Anesthesiologists (ASA) classification, preoperative education, and the need for blood transfusion [6][7][8][9][10][11][12][13]. Additionally, with the introduction of fast-track protocols, which emphasize pain and blood management, limit perioperative complications, and promote postoperative early ambulation, the LOS has decreased dramatically without compromising functional recovery [4,6].…”

Section: Introductionmentioning

confidence: 99%

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Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

Song

Xia

et al. 2020

BMC Musculoskelet Disord

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Background: Decreasing the length of hospital stay is an ideal course of action to appropriately allocate medical resources. The aim of this retrospective study was to identify perioperative factors that may decrease the length of hospital stay (LOS). Methods: In this study, we collected the data on 1112 patients who underwent primary total knee arthroplasty surgery (TKAs) at our institution from Jan 1, 2011 to Nov 31, 2017. Based on the published literature, 16 potential factors (12 preoperative variables, 1 intraoperative variable, and 3 postoperative variables) were investigated. The patients requiring a hospital stay longer than the mean LOS (8 days) were defined as patients with a prolonged LOS. The factors with a P value less than 0.1 in the univariate analysis were further analysed in a multivariate model. An ordinal regression was used to determine independent risk factors for a prolonged LOS. Results: The mean LOS was 8.3 days (±4.3), with a range of 2 to 30 days. Sixteen variables were analysed by univariate analysis, and 11 of them had p < 0.1 and were included in the multivariable model. Finally, 9 factors were found to be associated with a prolonged LOS. Among the 9 variables, 2 were surgery-related factors (operative time and intraoperative blood loss), and 3 were patient-related factors (age, ASA classification and neurological comorbidities). Conclusion: In this study, we found that the clinical protocol, complications, the patient's age, the ASA classification, neurological comorbidities, the operative time, the ward, intraoperative blood loss and the surgeon were all factors contributing to a prolonged LOS. In clinical practice, these factors provide important information for the surgeon and are useful for identifying patients with a high risk of a prolonged LOS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

Song

Xia

et al. 2020

BMC Musculoskelet Disord

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“…Dalgaard et al investigated ‘clinical phases in incurable illness trajectories’ which seemed difficult to do outside the hospital whereas it should be possible to study ‘perceptions of illness based on abnormal smears’ outside the hospital. Traditionally, a hospital is ‘the natural context of nursing’, since this is where nurses mostly train their practical skills during their education and some may be employed in afterwards during research and development studies . Spradley urged researchers to choose social situations with frequently recurring activities.…”

Section: Discussionmentioning

confidence: 99%

The state of Danish nursing ethnographic research: flowering, nurtured or malnurtured – a critical review

Uhrenfeldt

Martinsen

Jørgensen

et al. 2017

Scandinavian Caring Sciences

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“…There were two main weaknesses identified in the included studies. Five of the seven studies were unclear of their reporting of the relationship between participants and researcher (Montin et al 2002;Fielden et al 2003;Rastogi et al 2007;Hunt et al 2009;Specht et al 2016 The other main weakness was lack of consideration to ethical issues in two of the studies (Hunt et al 2009;Fujita et al 2006). One of the roles of an ethics committee is to challenge and discuss the methods of the study so that participants safety is met (Yank and Rennie 2002).…”

Section: Quality Of Studiesmentioning

confidence: 99%

What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review

Dore-Smith

Killingback

2018

Physical Therapy Reviews

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Background There are an increasing number of people undergoing hip and knee joint replacement each year; approximately 68,000 hip and 76,000 knee replacements respectively are performed in England and Wales. Joint replacements serve to reduce pain and improve function. Objective The purpose of this qualitative literature review is to gain an in depth understanding into participants' postoperative experiences following hip and knee replacement in order to establish if participants can be better supported post joint replacement and whether preoperative education can be enhanced. Method Searches were carried out in 13 online scientific databases (January 1995 to October 2016) to identify relevant studies. The quality of studies was assessed, data were extracted and analysed using thematic synthesis. Results A total of 197 studies were identified and screened against the inclusion/exclusion criteria. Seven studies met the inclusion criteria. Three broad themes were identified; coping with pain, recovering function and the challenges of discharge. In general pain was poorly understood and difficulties arose with the appropriate management postoperatively. The recovery process took commitment and required individuals to have realistic expectations. Participants also felt the need for individualised care as they approached discharge. Conclusion Overall qualitative evidence surrounding postoperative views of participants is limited. It appears current preoperative education does not fulfil the majority of participants' needs. Utilising the views of participants may help to tailor preoperative education or provide alternative support postoperatively. Future research should focus on clarifying the effect of a well constructed and well-delivered pre-operative education sessions.

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Patient experience in fast‐track hip and knee arthroplasty – a qualitative study

Cited by 59 publications

References 20 publications

Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China

The state of Danish nursing ethnographic research: flowering, nurtured or malnurtured – a critical review

What are the postoperative experiences of patients who have undergone hip and knee joint replacement? A literature review

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