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Journal of Nursing ›› 2020, Vol. 27 ›› Issue (21): 33-39.doi: 10.16460/j.issn1008-9969.2020.21.033

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Development of Evidence-based Practice Protocol for Enhanced Recovery after Total Knee Arthroplasty

SHAN Ya-wei1, CHEN Wei-jia2a, JIN Li-juan2b, FENG Hai-ping2b, CHEN Ru2c, FENG Cheng-cheng2c   

  1. 1. School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
    2a. Dept. of Nursing Administration; 2b.Dept. of Joint Surgery; 2c. Operating Room,Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, China
  • Received:2020-07-02 Online:2020-11-10 Published:2020-12-15

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Abstract: Objective To develop an evidence-based protocol to facilitate best practice for enhanced recovery after total knee arthroplasty (TKA). Methods Guided by the lowa model, evidence-based guidelines were retrieved, screened and eventually included. The best practice protocol was developed according to the recommendations synthesized by experts through 2-round Delphi survey and patients' experience by using qualitative interview. Results Consensus was reached on 43 recommendations from 12 evidence-based guidelines. Taking the health problems in perioperative period summarized in qualitative interview into consideration, we synthesized 9 preoperative modules including the risk factor for rehabilitation, anxiety and hyposomnia, pain, nutrition, hemorrhage control, deep venous thrombosis prevention, constipation prevention, infection prevention and rehabilitation training, 1 intraoperative module, namely, the operation and 8 post-operative modules including pain, nutrition, constipation prevention, drainage and bleeding, deep venous thrombosis prevention, exercise and rehabilitation, infection prevention, anxiety and hyposomnia. Conclusion The developed protocol is based on best evidence and combined with clinical practice, the suggestion from medical staff and patients' experience. It provides management strategy for improving quality of rehabilitation services after TKA.

Key words: total knee arthroplasty, enhanced recovery after surgery, evidence-based practice

CLC Number: 

  • R47
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