Day two post operative ‘fast-track’ discharge following primary total hip replacement

O’Brien, Seamus; Ogonda, Luke; Dennison, Janice; Doran, E.; Lawlor, Marie; Humphreys, Patricia; Kelly, Paul; Matthews, Liz; Beverland, David

doi:10.1016/j.joon.2005.05.002

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…16 Overall LOS increased only slightly with age and was lower than reported in most recent studies, 3 7 8 10 17 18 despite being in unselected consecutive patients, in contrast to previous studies. 6 13 Importantly, THA and TKA patients in Denmark are discharged to their own homes and not to rehabilitation units. Furthermore, our LOS includes transferral to other hospital departments.…”

Section: Discussionmentioning

confidence: 99%

Role of patient characteristics for fast-track hip and knee arthroplasty

Jørgensen

Kehlet

2013

British Journal of Anaesthesia

168

150

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Section: Discussionmentioning

confidence: 99%

Role of patient characteristics for fast-track hip and knee arthroplasty

Jørgensen

Kehlet

2013

British Journal of Anaesthesia

168

150

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“…Whether short stay influences recovery is not yet clear 9,10 . However, short stay certainly reduces the time available to clinical staff for management of aspects of short‐term physiological and subjective recovery that are likely to be important to patients.…”

Section: Introductionmentioning

confidence: 99%

Early discharge following hip arthroplasty: patients’ acceptance masks doubts and concerns

Hunt

Hall

O’Brien³

et al. 2009

Health Expectations

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Objective To describe patientsÕ experience of accelerated discharge after hip arthroplasty in order to test the acceptability to patients of economically driven shortening of post-operative stay.Methods Patients (n = 35) who had received primary total hip replacement up to 12 weeks previously were recruited from two UK orthopaedic units, one of which has pioneered short post-operative stay (3-4 days), and another one of which retains a traditional regimen of discharge after 6-7 days. Patients were interviewed about their experience of care, focusing particularly on their views related to length of stay and with particular attention to patientsÕ wellknown tendency to mask critical views of their care. Transcripts were analysed thematically to identify the ways that patients evaluated their care and whether these differed between sites.Results Patients were primarily concerned with how attentive and informative hospital staff had been and did not refer to length of stay spontaneously. When prompted about this, they did not question their discharge time, although those in the more traditional unit could not countenance more rapid discharge. Patients in the unit with accelerated discharge described concerns about the consequences of early discharge for them or their family, particularly managing pain and mobility problems at home and needing more support.Conclusions PatientsÕ traditional beliefs about the necessity of prolonged convalescence are not a barrier to early discharge after hip arthroplasty. Nevertheless, some patientsÕ acceptance of early discharge masks doubts and concerns. More intensive post-operative management may be needed if clinical care is not to suffer.

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“…2 A utilização de uma menor incisão cirúrgica e um protocolo de reabilitação "fast-track" para pacientes previamente selecionados já está permitindo uma mobilização e alta rapidamente.O estudo demonstrou que os pacientes que foram para casa no segundo dia de pós-operatório eram tipicamente mais magros (como evidenciado pelo IMC de 27,6Kg),quando comparados ao conjunto da população de pacientes(IMC de 29,5Kg) e mais jovens (idade média de 59), saudáveis (todos ASA 1ou 2), e do sexo masculino. 17 Estudo realizado no ano de 1976 demonstrou que a antissepsia cuidadosa da pele com compostos de quaternários de amônio a 1% no pré, trans e pós-operatório de ATQ, iniciada no momento da internação, incluindo a tricotomia do abdômen, coxas e períneo comprovaram, através de controle bacteriológico, que houve significativa diminuição da flora bacteriana por conta do método de anti-sepsia e do próprio antisséptico. 18 Atualmente, o preparo da pele é feito com solução degermante de PVPI ou Clorhexidina na sala de cirurgia,obedecendo norma internacional 19 e a tricotomia, quando necessária, é realizada, no máximo, duas horas antes da cirurgia, evitando assim o crescimento bacteriano.…”

Section: Métodounclassified

Assistência ao paciente submetido à artroplastia total de quadril: o saber da enfermagem traumato-ortopédica

Vital

Cameron

2009

Rev enferm UFPE on line.

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Objective: to achieve a mapping of national and international scientific productions about nursing care to patients that were submitted or will be submitted to hip arthroplasty. Methods: this is an exploratory and transverse study that sought to characterize the cross scientific production on the nursing care in hip arthroplasty and the articles were searched on LILACS, MEDLINE, Pubmed, SciELO and BDENF Virtual Libraries in the period of 1976-2008 and were founded 239 publications, the most ever published in international journals. Results: from these, we selected 23 articles, which had full access whether they were in Portuguese or English and was observed that there is a shortage in national scientific productions about this thematic in nursing area and a necessity of more researches. Conclusion: the analysis showed it’s necessary that more studies must be done to attend the clients’ necessities and the nurses that work on the Orthopaedic nursing area must discuss and go further in the treatment to be institutionalized pre, trans and pos surgical hip arthroplasty for a good attendance to the clients, reduce the troubles and costs. Descriptors: orthopedic nursing; nursing care; patient care; hip arthroplasty.

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Day two post operative ‘fast-track’ discharge following primary total hip replacement

Cited by 12 publications

References 7 publications

Role of patient characteristics for fast-track hip and knee arthroplasty

Role of patient characteristics for fast-track hip and knee arthroplasty

Early discharge following hip arthroplasty: patients’ acceptance masks doubts and concerns

Assistência ao paciente submetido à artroplastia total de quadril: o saber da enfermagem traumato-ortopédica

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