ประสิทธิผลของการใช้ชุดการดูแลในผู้สูงอายุที่ได้รับการผ่าตัดเปลี่ยนข้อเข่าเทียม หอผู้ป่วยพิเศษ 10 โรงพยาบาลมหาราชนครเชียงใหม่

Abstract

Elderly undergoing knee joint arthroplasty from hospitalization through to discharge need appropriate care bundles.These are beneficial for early recovery, ongoing activities of daily living, post operative complication prevention and quality of life. This operation study was undertaken by using the post operative knee joint arthroplasty care bundles of Baker, Preez, and Barlow (2011). The research populations were a health care team composed of 10 registered nurses and 5 practical nurses and 2 groups of 15 purposively sampled elderly undergoing knee joint arthroplasty in private ward 10, Maharaj Nakorn Chiang Mai Hospital during May to August 2014. The model of the Registered Nurses’ Association of Ontario (RNAO, 2012) was applied as a framework for this study. The instruments for data collection were the demographic data record form, data record form for range of knee extension and flexion motion, the 6 minutes walk test data form and length of stay data form. Data analysis was carried out using descriptive statistics. The results of the study revealed that: 1. The elderly with knee joint post operative care bundles implementation were able to do a range of knee extension at 0 within 24, 48 and 72 hours after surgery and on the day of discharge at percentages of1(16.67), 3 (50.00), 3 (50.00) and 6 (100) respectively. Those who did not receive knee joint post operative care bundles showed percentages of 4 (44.44), 4 (44.44), 4 (44.44) and 8 (88.89) respectively. With knee flexion angle at 90°, within 24, 48 and 72 hours after surgery and on the day of discharge elderly with knee joint care bundles could efficiently perform 1(16.67), 3(50.00), 3(50.00) and 6(100) respectively; while the group of elderly without care bundles implementation could perform only on the day of discharge at a percentage of 55.56. 2. Walking distance, measured by using a 6 minutes walk test, showed the elderly with knee joint post operative care bundles within 24, 48 and 72 hours after surgery and on the day of discharge were average at 0.13, 6.55, 25.85 and 71.65 meters respectively. While the group of elderly without care bundles were only able to perform 72 hours after surgery at the average of 5.34 meters and on the day of discharge at 10.82 meters. 3. The average length of stay with knee joint post operative care bundles was 10.83 days. While the group of elderly without care bundles implementation was 12.56 days. 4. The group of elderly with knee joint post operative care bundles showed a high level of satisfaction at a percentage of 83.33. 5. The satisfaction of the health care team after knee joint post operative care bundles showed a high level of satisfaction at a percentage of 84.61. The study showed that the knee joint post operative care bundles can efficiently recover and decrease length of hospitalization of the elderly undergoing knee joint arthroplasty. Therefore, care bundles should be applied to improve quality of nursing care for the elderly undergoing knee joint arthroplasty.