Abstract:

Objective To construct an evidence-based practice program of discharge preparation services for hip replacement patients based on the best evidence，and to evaluate its clinical effects，aiming to provide references for the implementation of relevant interventions. Methods Knowledge to Action Framework was used as a guide to summarise the best evidence on discharge preparation services for hip replacement patients and to select services based on clinical context. We selected 38 hip replacement patients and 17 healthcare professionals from the Department of Orthopaedic Surgery at a tertiary A hospital in Shanghai in September-October 2023 to conduct a baseline review, identify facilitating and hindering factors，and develop a practice protocol. We also selected 38 hip replacement patients and 17 healthcare professionals from November-December 2023 on this ward for evidence-based practice. Nurses’ rates of completion of review indicators，levels of knowledge of discharge preparation services，and discharge planning competencies were compared before and after practice. Patients’ readiness for discharge，hip function，and unplanned readmissions were also compared before and after the practice. Results After evidence-based practice，nurses’ completion rates of review indicators，knowledge of discharge preparation services，and discharge planning competencies were higher than baseline levels（P<0.05）. Hip replacement patients showed a significant improvement in readiness for discharge and hip function（P<0.001）. Conclusion The implementation of an evidence-based practice program of discharge preparation services improves nurses’ knowledge and skills，and also contributes to the discharge readiness and hip function of hip replacement patients.

Key words: Hip Replacement, Discharge Preparation Service, Knowledge to Action Framework, Evidence-Based Nursing

摘要：

目的 基于最佳证据构建髋关节置换患者出院准备服务的循证实践方案，并评价其应用效果，旨在为实施相关干预提供借鉴。方法 以知识转化框架为指导，汇总髋关节置换患者出院准备服务的最佳证据，根据临床情境选择服务内容。选择上海市某三级甲等综合医院矫形外科2023年9月—10月的38例髋关节置换患者和17名医护人员开展基线审查、识别促进与阻碍因素，制订实践方案；选择该病区2023年11月—12月的38例髋关节置换患者和17名医护人员开展循证实践。比较实践前后护士的审查指标完成率、出院准备服务知识水平和出院计划能力与患者的出院准备度、髋关节功能和非计划性再入院情况。结果 循证实践后，护士审查指标完成率、出院准备服务知识、出院计划能力均高于循证实践前，差异具有统计学意义（P<0.05）。髋关节置换患者的出院准备度、髋关节功能均高于循证实践前，差异具有统计学意义（P<0.001）。结论 髋关节置换患者出院准备服务循证实践能够提升护士的出院准备服务知识与技能，有助于提升患者的出院准备度和髋关节功能。

关键词: 髋关节置换术, 出院准备服务, 知识转化框架, 循证护理学