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|Title:||A nurse-facilitated multi-media intervention to promote patient participation in care improves outcomes after Total Knee Replacement Surgery: results of a cluster randomised crossover trial.|
|Epworth Authors:||McDonall, Jo|
de Steiger, Richard
Total Knee Replacement Surgery
Goals Of Care
Interference Of Pain On Activities
Length of Stay
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Epworth/Deakin Centre for Clinical Nursing Research, Epworth Healthcare, Victoria, Australia.
|Citation:||Epworth Research Institute Research Week 2017; Poster 24: pp 48|
|Conference:||Epworth Research Institute Research Week 2017|
|Conference Location:||Epworth HealthCare Research Institute, Victoria, Australia|
|Abstract:||BACKGROUND: Patient participation in care is essential for ensuring safe and high quality healthcare however, processes for engaging patients, and the impact of participation on patient recovery is not well understood. The purpose of this research was to test the effectiveness of a bedside, multimedia, nurse-facilitated intervention (MyStay) in improving patient outcomes after knee arthroplasty. The multimedia intervention was designed to deliver information that was explicit, actionable, non-ambiguous and tailored specifically to the goals of care following surgery. METHODS: This study was designed as a cluster randomized, crossover trial. The primary outcome was patients' pain intensity on Day 3 postoperatively. Secondary outcomes were: interference of pain on activities, hospital length of stay, functional status, patients' satisfaction, complications and readmission rates at 28 days post discharge. Data were collected at three major time points: pre-admission (baseline), Day 3 postoperatively and Day 28 after discharge. A linear mixed model analysis was used to calculate the F-test to compare the means of the groups. Other outcome measures analysed used a linear mixed model approach and analogous methods developed for categorical data. RESULTS: A total of 241 patients (104 intervention group and 137 control group) took part in the trial from March 2014 to June 2015. Intervention group patients reported lower pain intensity on Day 3 (p = 0.037), stayed in hospital one day less (p = 0.041), were more likely to recommend the organization (p = 0.021) and reported higher overall satisfaction with care (p = 0.013). Incidentally, intervention group patients returned to full time work sooner after discharge (p = 0.039). CONCLUSIONS: The MyStay bedside, multimedia, facilitated intervention enhanced patient participation in their care after surgery and influenced outcomes. The findings of this study contribute to our evolving understanding of patient participation in acute care environments.|
|Affiliated Organisations:||Deakin University, Geelong. Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership|
Deakin University, Geelong. School of Nursing and Midwifery
Deakin University, Geelong. Centre for Quality andPatient Safety Research-Monash HealthCare Partnership
Alfred Health and Monash University, Department of Epidemiology and Preventative Medicine
The University of Melbourne, Department of Orthopaedic Surgery.
|Type of Clinical Study or Trial:||Crossover Design|
|Appears in Collections:||Rehabilitation|
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