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Author Hunt, M. openurl 
  Title Nurses can enhance the pre-operative assessment process Type Journal Article
  Year 2006 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal  
  Volume 12 Issue 10 Pages 20-22  
  Keywords Nursing specialties; Clinical assessment; Hospitals; Surgery  
  Abstract (up) This reports on an initiative at Whakatane Hospital, where a Nurse-Led pre-assessment (NLPA) was delivered at an outpatients clinic. NLPA involves taking a comprehensive medical history, a nursing assessment, physical examination, airway assessment, ordering appropriate investigations and carefully documenting the process and results. More valuably, it provides an opportunity for the patient to participate in planning their care. The aim of this initative was to short circuit delays and congestion in existing pre-assessment clinics, streamline the pre-assessment process and reduce the number of patient visits to hospital. Reducing cancellations of surgery (often on the day of surgery) and “did not appear” (DNA) numbers were also objectives. After a small pilot, a six-month trial was funded by the Ministry of Health. Over the six-month trial, 373 patients attended NLPA; 178 patients required anaesthetist review before surgery, and 198 could proceed directly to surgery following NLPA. An anonymous postal survey was made of patients, who indicated satisfaction with the service. Other outcomes are discussed, and the trial was deemed successful. Follow up plans have been disrupted by restructuring at the hospital and the clinic has yet to be implemented.  
  Call Number NRSNZNO @ research @ 1005 Serial 989  
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Author Chapman, C. openurl 
  Title The elective way: An exploration of pre-operative education for orthopaedic joint replacements Type
  Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library  
  Volume Issue Pages  
  Keywords Patient satisfaction; Surgery; Education  
  Abstract (up) This research paper provides a description and analysis of literature and research focusing on pre-operative education programmes available internationally and nationally for patients receiving total joint replacements. This discussion differentiates between pre-assessment and pre-operative education to provide an understanding that both aspects are important in there own right. Together pre-assessment and pre-operative education complement each other to provide total care for patients awaiting total joint replacement surgery. One way of alleviating apprehension experienced by the patient about their surgery is by providing appropriate joint replacement education programmes that meet their needs. This type of programme is a form of empowerment which provides patients with appropriate and relevant information. This allows the patient to be actively involved in their own care and enable them to make informed decisions. The importance of education, information and communication; anxiety and pain; family and peer support; mobility and insecurity is a common thread in the literature where patients describe their experiences and concerns following a total joint replacement. These concepts are discussed and related to why pre-operative education programmes are recommended to help alleviate patients concerns and are important in providing a total multidisciplinary approach to care.  
  Call Number NRSNZNO @ research @ 736 Serial 722  
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Author Marcinkowski, K.; McDonald, B. openurl 
  Title Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative Type Journal Article
  Year 2006 Publication Nursing Praxis in New Zealand Abbreviated Journal  
  Volume 22 Issue 3 Pages 15-21  
  Keywords Surgery; Hospitals; Economics  
  Abstract (up) This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.  
  Call Number NRSNZNO @ research @ 533 Serial 519  
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