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Differences in the care of patients after a complete knee and hip replacement from the standpoint of the nurse.
LUŇÁČKOVÁ, Jana
Complete knee and hip replacement are one of the most common surgical procedures in an orthopedic practice. The care of these patients places very high demands on the attending nurse and follows strict guidelines. The occurrence rate of indications for the knee/hip replacement has risen recently. The reason behind it is higher stress on the bearing joints due to alarming rise in obesity, arthritic changes in the joints etc. Surgical procedure can restore mobility and independence of the patient. Part of the successful postoperative care is a close cooperation with the physiotherapy specialist. Orthopedic nurses carry full responsibility for the patient's care and therefore should be informed on its specifics. The bachelor thesis is divided into two sections, theoretical and empirical. The theoretical section focuses on the anatomy of the knee and hip joint, history of the replacement procedure and its indications and contraindications. It also discusses the specifics of the care of the patient. The empirical section covers research. The objective of the thesis is to discover different aspects of nursing care of the patient after total hip replacement and knee replacement and to investigate whether nursing staff possesses the knowledge of these aspects. Three basic questions were formulated: 1. What are the differences in care between the total knee replacement and total hip replacement patients? 2. In what areas of patient care, according to the nurses' point of view, do these differences exist? 3. What areas of patient care after total knee/hip replacement do nurses find the most difficult? A qualitative research method has been used to accomplish results for this thesis. Data collection has been carried out through semi-structured interviews and assisted observations. The research has taken place at a single location, an orthopedic department of a hospital. The research was completely anonymous, interviews and observations took place from April 8th 2016 through May 31st 2016. A semi-structured interviews were used for the data collection. Nurses were given 14 basic questions (see Appendix) that were followed by additional sub-questions during the interviews. Then the interview results were sorted into groups by their category for better comprehension. An assisted observation was another technique used. The acquired data have been input into a prepared table (see Appendix). The interviews and observations were carried out with the same subjects/nurses. The data collected showed that the care of the total knee replacement patient does not fundamentally differ from that of a total hip replacement patient. The only differences found were those in positioning of the patient, utilization of compensation aids, rehabilitation care and, according to the nurses, also in prevention of possible complications. The most common problems occur in connection with the manipulation of the patient. Nurses seem to lack a clear guidance as to by who and how the patient should be informed prior to the replacement procedure. This bachelor thesis has been compiled in such a way as to outline basic overview of the patient care differences and to be used as an information source for the experienced as well as the inexperienced nursing staff. Practical aspect of this thesis is a proposal for a seminar (see Appendix) on the issue of patient care differences after a total knee/hip replacement.
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