Solution
Sumayya K. answered on
Sep 14 2020
INTRODUCTION
Large number of individuals undergo total hip replacement every year globally, with more than 95% leading a life with increased activity post-surgery (De l’Escalopier, Anract and Biau, 2016). The surgery causes physiological and psychological distress to individuals, even undesired complications (Stowers, 2014). The article examines the various pre-operative and post-operative care methods for maintaining the success of total hip replacement in severe debilitating osteoarthritis.
TOTAL HIP REPLACEMENT (THR)
Total hip replacement is a surgical intervention where the hip joint (“ball-and-socket”) is replaced by artificial structures called prostheses. It results in pain relief, increased mobility and improved quality of life. The major cause of THR is osteoarthritis. However, the prostheses are subjected to degradation in the long run. Therefore, THR is often recommended as the last resort when conservative treatments do not produce the desired results, say, in severe debilitating hip arthritis. (Erens, 2017), ,(De l’Escalopier, Anract and Biau, 2016), (Svege, Nordsletten, Fernandes, & Risberg, 2015). Total hip replacement is not known to have serious complications. However, all stages of perioperative care need to adopt adequate steps to prevent any complications like deep vein thrombosis, infection, pulmonary embolism (De l’Escalopier, Anract and Biau, 2016) and dislocation/ loosening/
eakage of the prostheses (Erens, 2017).
PRE-OPERATIVE CARE
Preadmission tests
Once the decision for surgery is made, all patients need to undergo routine tests like electrocardiogram, chest radiography, blood and urine tests. All the tests need to be based on physical checkups, medical history, age and sex. The tests help recognise risk factors, if any with timely actions to combat any evident issues. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA) tests are also employed to reduce risks of surgical wound infection (Mori, Hageman and Zimmerly, 2017).
Chlorhexidine gluconate bathing
Patients are recommended to bath with chlorhexidine gluconate (CHG) 4% from 5 days before the procedure including the morning of the surgery. CHG needs to be applied from neck to toe avoiding the vaginal region and wounds, if any. The product is known to successfully inhibit both gram-positive and gram-negative bacteria. Also, patients need to be encouraged to perform hand hygiene to prevent microbial transmission (Mori, Hageman and Zimmerly, 2017).
Patient education
Recent studies have shown that pre-operative education of patients have profound impacts on anxiety reduction, pain management, and to develop more pragmatic anticipations about the surgical results (Stowers, 2014). Therefore, timely and sufficient knowledge of the procedure and related outcomes cause shorter hospital stays, decreased readmissions and lowered healthcare costs. Pre-operative education is found to be more beneficial than post-operative learning. The process should start from the respective surgeon who explains the expectations, risks and alternatives of the intervention. Classes may be conducted by an orthopaedic nurse through ve
al, written or audiovisual means. One-to-one or group sessions may be conducted as required. A career designated as 'coach’ should accompany the patient to the classes in order to understand his/ her roles and responsibilities. Such classes should be able to promote maximum questions and fill all the relevant knowledge gap as possible. A combination of detailed clinical pathways (CP) and pre-operative education is gaining popularity in reducing readmission cases. (Edwards,Mears & Barnes, 2017)
Discharge planning
Pre-operative education by an occupational therapist help in better planning of post-operative functional performance with regards to the specified precautions. It also ensures that the patients make their houses suitable for the regular activities before...