Translating evidence-based protocol of wound drain management for total joint arthroplasty into practice: A quasi-experimental study

Tsang, Lap Fung; Cheng, Hang; Ho, Hon Shuen; Hsu, Yung Chak; Chow, Chiu Man; Law, Heung Wah; Fong, Lup Chau; Leung, Lok Ming; Kong, Ivy Ching Yan; Chan, Chun-Kit; Sham, Alice So Yuen

doi:10.1016/j.ijotn.2015.07.002

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…Moreover, in the subgroup analysis, there were no statistically significant differences found in terms of the type of intervention, debridement, cartilage repair, or fibular ligament suture. Historically, there is a consensus among surgeons that open and complex fractures with extensive soft tissue damage, as well as soft tissue infections of the foot an ankle, should be treated with a vacuum dressing [1,4,10,14,16]. However, there is no clear recommendation for elective surgery on the upper ankle.…”

Section: Discussionmentioning

confidence: 99%

Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study

Fischer

Heusgen

Brkic

et al. 2021

Arch Orthop Trauma Surg

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Introduction Closed suction drainage is an established procedure in arthroscopic surgery. It is intended to reduce the retention of wound and irrigation fluids, which form the basis for postoperative swelling, pain, and infection. However, currently, there is no scientific review of the actual benefit of this procedure. Methods Between 2020 and 2021, 84 patients (53 males, 31 females; mean age: 42 years) were prospectively randomised into this study. The patients underwent arthroscopic surgery of the ankle joint with (group A) or without (group B) insertion of a closed suction drain (42 patients per group). Assessments included upper ankle swelling using the figure-of-eight-20 method, pain preoperatively and 48 h postoperatively, and unexpected events within 6 weeks postoperatively. ResultsThe measurements performed 48 h postoperatively showed a mean circumferential increase of 1.38 cm (1.48 and 1.28 cm in groups A and B, respectively; p > 0.05) in all patients. The mean pain at rest, assessed using the visual analogue scale (maximum 10 points), was 2.7 and 2.4 in groups A and B, respectively (p > 0.05). Overall, two minor complications occurred: residual swelling in group A and persistent limitation of movement in group B. The average length of hospital stay was 2.4 days (p > 0.05). Conclusions Based on the available data, the routine insertion of a closed suction drainage at the upper ankle does not offer any objective benefit and must be considered obsolete. From both a medical and an economic point of view, the decision to conduct this procedure should be justified on an individual basis. Level of evidence Level I, prospective randomised trial.

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Section: Discussionmentioning

confidence: 99%

Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study

Fischer

Heusgen

Brkic

et al. 2021

Arch Orthop Trauma Surg

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“…Patient safety needs to be the priority to the health care team [44]. Studies show that the use of evidence-based protocols contributes to patient safety, because nurses are thereby trained in patient care and are given knowledge of drainage systems [45] and the types of drainage to expect from whichever device is inserted into a patient. They can also contribute to patient safety and prevent potential harm because they can collaborate in the rehabilitation process since adequate drainage management improves effectiveness [45].…”

Section: Use Of Protocols For Patient Safetymentioning

confidence: 99%

“…Studies show that the use of evidence-based protocols contributes to patient safety, because nurses are thereby trained in patient care and are given knowledge of drainage systems [45] and the types of drainage to expect from whichever device is inserted into a patient. They can also contribute to patient safety and prevent potential harm because they can collaborate in the rehabilitation process since adequate drainage management improves effectiveness [45]. In addition, some authors argue that protocols may improve communication between doctors and nurses during care and that a standardized document improves interdisciplinary communication and drainage care [45].…”

Section: Use Of Protocols For Patient Safetymentioning

confidence: 99%

Interdisciplinary teamwork for chest tube insertion and management: an integrative review

Ghazali¹,

Ilha-Schuelter²,

Barbosa³

et al. 2021

ait

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The importance of an interdisciplinary endeavour is the capacity of multiple professionals with different backgrounds working together to deliver higher quality care [1]. The concept of medicine as an isolated discipline concerned with the restoration of health has been replaced with the concept of different health professionals working together to maintain health [2]. This type of team-based learning can occur in either academic or clinical settings, during medical school and residency, and consist of any combination of professional groups [3]. Interdisciplinary collaboration in health care is crucial to offering patient-centred care, and working collaboratively is not only essential but also crucial in providing quality and safety in patient-centred care [2]. In the thoracostomy procedure, the physician/surgeon and nursing teams must work together to achieve patient care, sharing tasks and responsibilities [2].

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“…However, these are often inadequately completed (Francis 2013, Jeyapala et al 2015, and more comprehensive documentation is required (Table 1) (Lyons et al 2015, Tsang et al 2016. Lyons et al (2015) suggested that the information recorded on fluid balance charts is inadequate for the purpose of drain monitoring, indicating that there is insufficient space for the required recording of various aspects of drain monitoring, such as documenting multiple drains, position and type of drain, character of the fluid, running total, and 24-hour output from drains.…”

Section: Communication and Documentationmentioning

confidence: 99%

Effective drain care and management in community settings

Gibson

Lillie

2019

Nursing Standard

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The literature indicates that drain monitoring is a frequently undervalued aspect of patient care, and that the drain care provided is often inconsistent and inadequate. There are numerous potential implications of suboptimal drain care for patients, nurses, teams and healthcare organisations. Since acute care is increasingly being delivered in the community, there is a greater need for nurses to have an understanding of effective drain care. This article describes the rationale for drain insertion and its associated complications. It uses a case study to illustrate how suboptimal drain monitoring and documentation can negatively affect patient care and safety. This article also discusses several important issues raised in the case study, such as suboptimal documentation, and how these may have consequences for nurses, teams and healthcare organisations. Recognition of these elements supports initiatives that nurses could apply to practice to reduce the occurrence of similar incidents. • There is a need for comprehensive and consistent monitoring, management and care of drains. Nurses should promote optimal practice in drain care to maintain patient safety Key points • Drains are routinely used in post-operative practice as a prophylactic intervention to: reduce or eliminate blood, fluid or pus; remove air; or identify anastomotic leaks • Drain care and frequency of drain assessments are related to the drain type, function and position • An insufficient and non-systematic focus on drain care is associated with late identification of complications, resulting in inappropriate care or emergency hospital admissions, which can negatively affect patients' quality of life and physical functioning

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Translating evidence-based protocol of wound drain management for total joint arthroplasty into practice: A quasi-experimental study

Cited by 7 publications

References 18 publications

Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study

Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study

Interdisciplinary teamwork for chest tube insertion and management: an integrative review

Effective drain care and management in community settings

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