Journal of nursing care quality · 2024
Implementing a Frailty-Specific Postoperative Order Set to Improve Postoperative Outcomes in Frail Adults After Elective Thoracic Surgery.
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Allen Amani, Francisco Mary Ann, Jatis Jessica, Turner Yonous, Nordgren Rachel, Rubin Daniel, Huisingh-Scheetz Megan, Bryan Darren S, Donington Jessica, Ferguson Mark K, Gleason Lauren J, Madariaga Maria Lucia
Аннотация
BACKGROUND: Frailty is independently associated with adverse patient outcomes after surgery. The current standards of postoperative care rarely consider frailty status.
LOCAL PROBLEM: There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.
METHODS: A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.
INTERVENTIONS: A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.
RESULTS: There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).
CONCLUSIONS: Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.
LOCAL PROBLEM: There was no standardized protocol to optimize specialized postoperative care for frail patients at an academic medical center.
METHODS: A quasi-experimental pre-/postimplementation study design, using the Reach, Effectiveness, Adoption, Implementation, Maintenance implementation framework, was utilized.
INTERVENTIONS: A frailty-specific postoperative order set (FPOS) was developed, including tailored nursing care, activity levels, and nutritional goals.
RESULTS: There were significant improvements in nurse's self-reported familiarity with frailty ( P = .003) and FPOS awareness ( P < .001). The number of orders for delirium prevention, elimination, nutrition, sleep promotion, and sensory support increased ( P < .001).
CONCLUSIONS: Implementing an FPOS showed improvements in nurse frailty knowledge, awareness, and order set utilization.