| Objective1.Based on the Stetler model of researchutilization.A systematic search and evaluation of relevant guidelines for the frailty management of hip replacement in the elderly was conducted in order to obtain high-quality evidence as a basis for evidence-based practice,laying a foundation for the construction of frailty management nursing programs for elderly patients with hip replacement.2.Draft a preliminary plan for the frailty management nursing program of elderly patients with hip replacement,optimize the plan through the Delphi method of expert correspondence consultation,and finally construct a localized evidence-based practical nursing plan for the frailty management of elderly patients with hip replacement.3.Apply the frailty management care program for elderly patients with hip replacement into clinical practice,and judge the applicability and effectiveness of the plan in clinical application.MethodPart I Preliminary application of frailty management nursing program in elderly patients with hip replacement: Search,evaluate and collate of relevant guidelines at home and abroad for the frailty management of elderly patients with hip fracture.The expert meeting method was used to evaluate and make decisions on the retrieved guide items,and the evidence of the included guide items was summarized.The research team formulated the Expert Correspondence Questionnaire for Frailty Management Nursing Program in Elderly Patients with Hip Replacement,optimized the nursing plan through two rounds of Delphi expert correspondence,and formed the final frailty management plan.Part II Preliminary application of frailty management nursing program in elderly patients with hip replacement: Elderly patients who underwent hip replacement in the joint surgery department of a Grade-III hospital in Inner Mongolia from May 2022 to October 2022 and assessed as having frailty by the research team were selected and divided into both groups for the study: with the control group performing routine nursing in the department and the experimental group applying frailty management nursing program.The MNA-SF,Barthel index,Harris functional score on the day of admission,1 month postoperative and 3 months postoperative;the time to the first postoperative activity on the floor and unplanned readmission were compared between the two groups.Result1.The evidence was evaluated and analyzed through the expert meeting.Finally,50 pieces of evidence were included,44 pieces of A-level recommended evidence and 6 pieces of B-level recommended evidence.The frailty management nursing program for elderly patients with hip replacement was constructed through 2 rounds of expert correspondence consultation,including 3 primary indicators(early management of frailty,multi-dimensional management of frailty,continuous management of frailty),13 secondary indicators,and 40 tertiary indicators.The constructed frailty management plan is scientific,reasonable and guiding.2.The baseline general data of the two groups of patients were counted to be comparable(P>0.05).The MNA-SF,Barthel index scores and Harris function scores of patients at admission,1 month after surgery and 3 months after surgery were monitored.The data of MNA-SF and Barthel index conformed to normal distribution and were analyzed by repeated measures ANOVA,while the data of Harris function dimensions and total scores did not conform to normal distribution and were analyzed by generalized estimating equation,and the two groups of patients the scores showed an increasing trend with time,and the experimental group was better than the control group,and the scores were statistically different(P<0.05);the independent sample t-test was used to analyze the time spent on the first postoperative floor activity,and the time spent on the floor in the experimental group was less than that in the control group,and the difference was statistically significant(P<0.05),and no unplanned readmission occurred in both groups.Conclusion1.In this study,evidence-based questions were raised according to the symptoms of patients with hip arthroplasty frailty in clinical practice.The research team screened the guidelines and summarized the items.The evaluation,decision-making and evidence integration of the guidelines were carried out through expert meeting method and Delphi method,The established nursing program for the elderly patients with hip joint placement has good reliability and practicability,and can be used as a standardized practice process for the management of frailty.2.The application of frailty management nursing program based on Stetler model of researchutilization in elderly patients with hip replacement can improve patients’ frailty status and quality of life,and is worthy of further promotion and application in clinical practice. |
PDF Full Text Request