The Effectiveness of Nurse-Led Preoperative Assessment Clinics for Patients Receiving Elective Orthopaedic Surgery: A Systematic Review
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- 作者：Chan Sau-Man Conny ; DN ; MN ; RN ; connychan@cuhk.edu.hkAuthor Vitae ; Ip Wan-Yim ; PhD ; RNAuthor Vitae
- 关键词：surgery cancellation ; nurse-led clinic ; pre-operative assessment clinic ; orthopedic surgery
- 刊名：Journal of PeriAnesthesia Nursing
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：31
- 期：6
- 页码：465-474
- 全文大小：208 K
- 卷排序：31
文摘
Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care.DesignThe Joanna Briggs Institute (JBI) approach for conducting systematic review of quantitative research was used. Data bases searched included all published and unpublished studies in Chinese and English.MethodsAll studies with adult patients who required elective orthopaedic surgery e.g. total knee replacement, total hip replacement, reduction of fracture or reconstruction surgery etc. in a hospital or day surgery center and attended a nurse-led POAC before surgery were included.FindingsTen studies were critically appraised. Results showed that nurse-led POACs can reduce surgery cancellation rates. These studies suggested a reduction in the rate of postoperative mortality and length of hospital stay. In addition, the level of satisfaction towards services provided was significantly high.Conclusions and ImplicationsAlthough POACs are being increasingly implemented worldwide, the development of clinical guidelines, pathways and protocols was advocated. The best available evidence asserted that nurses in the POAC could serve as effective coordinators, assessors and educators. The nurse-led practice optimized patients' condition before surgery and hence minimized elective surgery cancellations.