| 1. |
- Bahtsevani, Christel, et al.
(författare)
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To Assess Prerequisites Before an Implementation Strategy in an Orthopaedic Department in Sweden
- 2016
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Ingår i: Orthopedic Nursing. - : Ingenta. - 0744-6020 .- 1542-538X. ; 35:2, s. 100-107
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Tidskriftsartikel (refereegranskat)abstract
- Promoting Action on Research Implementation in Health Services (PARiHS) asserts that the success of knowledge implementation relates to multiple factors in a complex and dynamic way, and therefore the effects of implementation strategies vary by method and context. An instrument based on the PARiHS framework was developed to help assess critical factors influencing implementation strategies so that strategies can be tailored to promote implementation. The purpose of this study was to use the Evaluation Before Implementation Questionnaire (EBIQ), to describe staff perceptions in one orthopaedic department, and to investigate differences between wards. Staff members in four different wards at one orthopaedic department at a university hospital in Sweden were invited to complete a questionnaire related to planning for the implementation of a clinical practice guideline. The 23 items in the EBIQ were expected to capture staff perceptions about the evidence, context, and facilitation factors that influence the implementation process. Descriptive statistics and differences between wards were analyzed. Although the overall response rate was low (n = 49), two of the four wards accounted for most of the completed questionnaires (n = 25 and n = 12, respectively), enabling a comparison of these wards. We found significant differences between respondents' perceptions at the two wards in six items regarding context and facilitation in terms of receptiveness to change, forms of leadership, and evaluation and presence of feedback and facilitators. The EBIQ instrument requires further testing, but there appears to be initial support for pre-implementation use of the EBIQ as a means to enhance planning for implementation.
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| 2. |
- Conley, Robert B., et al.
(författare)
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Secondary Fracture Prevention : Consensus Clinical Recommendations from a Multistakeholder Coalition
- 2020
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Ingår i: Orthopaedic Nursing. - 0744-6020. ; 39:3, s. 145-161
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Tidskriftsartikel (refereegranskat)abstract
- Osteoporosis-related fractures are undertreated, due in part to misinformation about recommended approaches to patient care and discrepancies among treatment guidelines. To help bridge this gap and improve patient outcomes, the American Society for Bone and Mineral Research assembled a multistakeholder coalition to develop clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture. The coalition developed 13 recommendations (7 primary and 6 secondary) strongly supported by the empirical literature. The coalition recommends increased communication with patients regarding fracture risk, mortality and morbidity outcomes, and fracture risk reduction. Risk assessment (including fall history) should occur at regular intervals with referral to physical and/or occupational therapy as appropriate. Oral, intravenous, and subcutaneous pharmacotherapies are efficacious and can reduce risk offuture fracture. Patients need education, however, about the benefits and risks of both treatment and not receiving treatment. Oral bisphosphonates alendronate and risedronate are first-line options and are generally well tolerated; otherwise, intravenous zoledronic acid and subcutaneous denosumab can be considered. Anabolic agents are expensive but may be beneficial for selected patients at high risk. Optimal duration of pharmacotherapy is unknown but because the riskfor second fractures is highest in the early post-fracture period, prompt treatment is recommended. Adequate dietary or supplemental vitamin D and calcium intake should be assured. Individuals being treated for osteoporosis should be reevaluated for fracture risk routinely, including via patient education about osteoporosis and fractures and monitoring foradverse treatment effects. Patients should be strongly encouraged to avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies. Finally, referral to endocrinologists or other osteoporosis specialists may be warranted for individuals who experience repeated fracture or bone loss and those with complicating comorbidities (eg, hyperparathyroidism, chronic kidney disease). (c) 2019 American Society for Bone and Mineral Research.
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| 3. |
- Klemetti, Seija, et al.
(författare)
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Information and Control Preferences and Their Relationship With the Knowledge Received Among European Joint Arthroplasty Patients.
- 2016
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Ingår i: Orthopedic Nursing. - : Lippincott Williams & Wilkins. - 0744-6020 .- 1542-538X. ; 35:3, s. 174-182
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The prevalence of joint arthroplasties is increasing internationally, putting increased emphasis on patient education. PURPOSE: This study describes information and controlpreferences of patients with joint arthroplasty in seven European countries, and explores their relationships with patients' received knowledge. METHODS: The data (n = 1,446) were collected during 2009-2012 with the Krantz Health Opinion Survey and the Received Knowledge of Hospital Patient scale. RESULTS: European patients with joint arthroplasty had low preferences. Older patients had less information preferences than younger patients (p = .0001). In control preferences there were significant relationships with age (p = .021), employment in healthcare/social services (p = .033), chronic illness (p = .002), and country (p = .0001). Received knowledge of the patients did not have any relationships with information preferences. Instead, higher control preferences were associated with less received knowledge. CONCLUSION: The relationship between European joint arthroplasty patients' preferences and the knowledge they have received requires further research.
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| 4. |
- MacDonald, Valerie, et al.
(författare)
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Developing and Testing an International Audit of Nursing Quality Indicators for Older Adults With Fragility Hip Fracture
- 2018
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Ingår i: Orthopedic Nursing. - : Lippincott Williams & Wilkins. - 0744-6020 .- 1542-538X. ; 37:2, s. 115-121
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fragility hip fracture in older adults often has poor outcomes, but these outcomes can be improved with attention to specific quality care indicators. PURPOSE: The International Collaboration of Orthopaedic Nursing (ICON) developed an audit process to identify the extent to which internationally accepted nursing quality care indicators for older adults with fragility hip fracture are reflected in policies, protocols, and processes guiding acute care. METHODS: A data abstraction tool was created for each of 12 quality indicators. Data were collected using a mixed-methods approach with unstructured rounds. A rationale document providing evidence for the quality indicators and a user evaluation form were included with the audit tool. A purposeful sample of 35 acute care hospitals representing 7 countries was selected. RESULTS: Thirty-five hospitals (100%) completed the survey. Respondents viewed the content as relevant and applicable for the defined patient population. Although timing and frequency of implementation varied among and within countries, the identified quality indicators were reflected in the majority of policies, protocols, or processes guiding care in the hospitals surveyed. CONCLUSION: Developing and testing an audit of nurse-sensitive quality indicators for older adults with fragility hip fracture demonstrate international consensus on common core best practices to ensure optimal acute care.
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| 5. |
- Olofsson, Birgitta, et al.
(författare)
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Mental status and surgical methods in patients with femoral neck fracture
- 2009
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Ingår i: Orthopedic Nursing. - 0744-6020 .- 1542-538X. ; 28:6, s. 305-313
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: About one third of hip-fractured patients have dementia and thus may have difficulties adhering to postoperative instructions. Hip replacement is the most common treatment when a femoral neck fracture is displaced in healthy older people, whereas for those with dementia and other severe comorbidities, internal fixation (IF) is generally recommended.PURPOSE: To evaluate complications, functional outcome, and mortality for both surgical methods, IF and hemiarthroplasty (HAP), in older patients suffering from femoral neck fracture with or without dementia. SAMPLE: One hundred eighty patients, aged 70 years or older, who were operated on using IF (n = 69) in undisplaced femoral neck fracture and HAP (n = 111) if the fractures were displaced.DATA COLLECTION: Mental state was assessed using the Mini-Mental State Examination and Organic Brain Syndrome scale, and dementia and delirium were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Outcomes of mortality, complications, functional ability, and quality of life were measured.FINDINGS: There was no difference in complications or mortality at 4 months and 1 year for the IF or HAP groups. Patients with and without dementia, operated on with HAP, had a better functional outcome after 1 year than those operated on with IF. The result of this study indicates that dementia per se is not a reason for disqualifying those patients from the most appropriate surgical method.
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| 6. |
- Rullander, Anna-Clara, et al.
(författare)
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Adolescents' experiences of scoliosis surgery and the trajectory of self-reported pain : a mixed-methods study
- 2017
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Ingår i: Orthopedic Nursing. - : Lippincott Williams & Wilkins. - 0744-6020 .- 1542-538X. ; 36:6, s. 414-423
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Tidskriftsartikel (refereegranskat)abstract
- Scoliosis surgery for adolescents is a major surgery with a diffi cult recovery. In this study, a mixed-methods design was used to broaden the scope of adolescents' experiences of surgery for idiopathic scoliosis and the trajectory of self-reported pain during the hospital stay and through the fi rst 6 months of recovery at home. Self-reports of pain, diaries, and interviews were analyzed separately. The results were then integrated with each other. The trajectory of self-reported pain varied hugely between individuals. Adolescents experienced physical suffering and struggled to not be overwhelmed. The adolescents described the environmental and supportive factors that enabled them to cope and how they hovered between suffering and control as they strived toward normality. This study highlights areas of potential improvement in perioperative scoliosis care in terms of nursing support and pain management.
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| 7. |
- Rullander, Anna-Clara, et al.
(författare)
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Young People's Experiences With Scoliosis Surgery A Survey of Pain, Nausea, and Global Satisfaction
- 2013
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Ingår i: Orthopedic Nursing. - 0744-6020 .- 1542-538X. ; 32:6, s. 327-333
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Scoliosis surgery is one of the most extensive elective surgical processes performed on young people. Although there is a great store of knowledge of surgical techniques, patients' experiences of going through surgery have not been extensively studied. PURPOSE: The aim of this study is to describe how a cohort of young people and their parents retrospectively rate postoperative pain and nausea and describe their experiences of scoliosis surgery. METHODS: In a retrospective cohort study, 87 young people aged 8-25 years with scoliosis who underwent corrective surgery from 2004 to 2007 were invited to complete a questionnaire, as were their parents. The semistructured questionnaire dealt with experiences of pain, nausea, and global satisfaction pre- and posthospitalization, assessed by visual analogue scales. The free text commentaries were analyzed using qualitative content analysis. RESULTS: A total of 51 patients (59%) and 65 parents (75%) answered the questionnaires. Out of the completed questionnaires, 41 had idiopathic, 23 neuromuscular, and 6 other types of scoliosis. Postoperative patient-rated pain was severe 7.3 (median, interquartile range 5-8.4, visual analogue scale 0-10 cm), and the severe pain lasted for 5 (median, 2.7-7.0) days. Nausea was rated to a median of 5 (1.1-7.3) and lasted for a median of 3 (1-5.2) days. Global satisfaction was rated to a median of 3.2 (1.5-5.2). Postoperative pain was the most prominent issue, and present pain was found in 51% of respondents. Nausea and loss of appetite were common during the entire hospital stay. Waiting for the nurses' assistance, lack of control, and technical failures with the analgesia equipment caused discomfort. Parents experienced a lack of confidence in the nurses and felt helpless to support their child or relieve the child's suffering. CONCLUSION: Young people who underwent scoliosis surgery reported severe postoperative pain and nausea during the hospitalization period and persistent and recent onset pain after discharge, although they did not indicate global dissatisfaction with the hospital stay.
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| 8. |
- Segevall, Cecilia, et al.
(författare)
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The Journey Toward Taking the Day for Granted Again : The Experiences of Rural Older People's Recovery From Hip Fracture Surgery
- 2019
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Ingår i: Orthopedic Nursing. - 0744-6020 .- 1542-538X. ; 38:6, s. 359-366
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A hip fracture is an unexpected, subjective, traumatic experience that affects the person in both physical and emotional ways.PURPOSE: The purpose of this study was to describe rural older people's experiences of recovering after hip fracture surgery.METHODS: Thirteen individual interviews were conducted with older people. The interview texts were analyzed with qualitative content analysis.RESULTS: Patients described finding themselves in a new and vulnerable situation, dependent on others for simple everyday chores. They struggled to regain independence while staying positive, convinced that they would recover. Fear of another fall, as well as lack of information, made recovery at home difficult.CONCLUSION: Older people who experience hip fractures need support during the recovery process. Because recovery begins at the hospital, this study highlight patients' need to participate in recovery planning, as well as the need to have information about what it means to be affected by a hip fracture and how to prevent it from happening again. This study emphasizes that nurses' awareness of patients' need to participate in planning the recovery process is crucial for enabling patients' return to a daily life that is similar to their prefracture life.
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| 9. |
- Sterner, Eila, et al.
(författare)
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Category I pressure ulcers : how reliable is clinical assessment?
- 2011
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Ingår i: Orthopedic Nursing. - 0744-6020 .- 1542-538X. ; 30:3, s. 194-205
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Tidskriftsartikel (refereegranskat)abstract
- finger-press tests and visual observation alone were not reliable methods to discriminate between blanching and nonblanching erythema. Forty-seven percent of the patients had a risk score 20 or fewer (high risk for pressure ulcers). Forty-four patients (56%) had pressure ulcers at discharge.
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| 10. |
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