Effect of Educational Program on Nurses' Knowledge, Practices and Patients' Outcomes Post Total Knee Arthroplasty

Abstract

Context: Total knee arthroplasty (TKA) is a surgical procedure in which the damaged parts of the patient's kneecap, thighbone, and shinbone are replaced with artificial parts.
 Aim: This study aimed to evaluate the effect of an educational program on nurses' knowledge, practices, and patients' outcomes post total knee arthroplasty.
 Methods: A quasi-experimental design was utilized in the orthopedic department and outpatient orthopedic clinic affiliated to Benha University Hospital from the beginning of July 2020 to the end of June 2021. A convenience sample of all available nurses (50) working in the orthopedic department. A purposive sample of 64 adult patients from both genders was divided into (32) control and (32) study groups. Three tools were used: The nurses' knowledge assessment questionnaire, nurses' practice observational checklist, and patient’ outcomes assessment sheet.
 Results: The present study revealed that 58% of nurses age was from 40 to less than 60 years old, 92% were females, 66% had secondary nursing education, 28 % of studied nurses had total satisfactory knowledge pre-program implementation, which reached 80%, 58 %, respectively immediately after and in follow up of program implementation. 22% of studied nurses had a competent level of practice scores pre-program implementation, which improved to 82%, 74 %, respectively, immediately after and in follow up of program implementation. There were highly statistically significant differences between study and control group patients regarding the frequency of most of the general and local complication and lower extremity function scale after two weeks and one month post-surgery at p-value<0.00.
 Conclusion: Implementing the educational program had statistically significantly improved the knowledge and practices of the studied nurses that could reflect positively on patient condition. The study recommended a continuous educational program for all nurses working in the orthopedic departments. Further study to search the correlation between the nurses' performance and the patient outcomes is recommended.

Assessment for Nurses’ Practices Regarding Pre and Postoperative Care for Patients with Total Knee Arthroplasty

“…Concerning total score of nurses' practices regarding pre and postoperative care of patient with total knee arthroplasty, more than two thirds of the studied nurses had incompetent level of practices regarding pre and postoperative care of patient with total knee arthroplasty. This result is identical with a study done by Taha & Ibrahim, (2021), entitled effect of educational program on nurses' knowledge, practices and patients' outcomes post total knee arthroplasty which showed that less than one third of studied nurses had a competent level of practice scores. Moreover, the current results were in consistent with Healy.…”

“…Regarding demographic data (age) most of the studied nurses were with a mean age 26.71±4.26 years, this result was in identical line with Aldakheel, (2021), a study performed to assess nurses" knowledge concerning knee arthroplasty and illuminated that more than half of the studied nurses aged between 20-29 years old. On the same line, this result agreed with the study conducted by El-Sayed et al (2016) (2015), who reported that most studied nurses had a Baccalaureate degree in nursing education, also not agreed with Taha & Ibrahim, (2021), which revealed that two third of studied nurses had secondary school nursing education. Concerning years of experience in orthopedic unit, more than two thirds of studied nurses ranged from 1-6 years of experience in orthopedic unit, these results was in line with Aldakheel, (2021), that revealed that most of studied nurses had between 1 to 8 years of experience, Also, those results concur with a study done by Causey-Upton, et al (2020), a study performed to assess orthopedic nurses' perceptions of preoperative education for total knee replacement, revealed that most of nurses working in the orthopedic units ranged from 1-10 years of experience.…”