Abstract:

Objective To summarize the best available evidence of discharge follow-up of patients after knee arthroplasty,and to provide reference for clinical practice. Methods We searched National Guideline Clearinghouse,National Institute for Health and Care Excellence,the Scottish Intercollegiate Guidelines Network,Canadian Medical Association Infobase（CMA）,Guidelines International Network（GIN）,and National Health And Medical Research Council（NHMRC）,Registered Nurses’Association of Ontario（RNAO）,Cochrane Library,JBI Library,CINAHL,Uptodate,BMJ best practice,Embase,Pubmed,CNKI,Wanfang Data,China Biology Medicine disc（CBM） and the VIP Database（VIP） for all evidence of discharge follow-up of patients who underwent knee arthroplasty,including guidelines,systematic reviews,evidence summary,recommended practices,and original studies. Results A total of 9 articles were selected in the literature,including 1 clinical decision,2 guidelines,3 systematic reviews,1 randomized controlled trial,2 expert consensuses. Finally 17 items of best evidence were summarized and categorized into 5 dimensions of recommendations,including follow-up time and method,physical assessment,drug management,discharge rehabilitation,and health education. Conclusion This study summarized the best evidence of discharge follow-up after knee arthroplasty,and nurses should receive relevant training to apply the best evidence to clinical practice. When applying the best evidence,medical staff should consider the patient’s wishes and specific clinical conditions,and combine professional judgment to form an effective and feasible follow-up strategy to improve the quality of nursing quality.

Key words: Arthroplasty, Replacement, Knee, Aftercare, Follow-up, Rehabilitation Nursing, Evidence-Based Nursing

摘要：

目的 总结膝关节置换术后患者出院随访的最佳证据,为临床实践提供参考。 方法 计算机检索美国指南网、英国卫生与临床优化研究所、苏格兰学院间指南网、加拿大临床医学实践网、国际指南网、澳大利亚国家卫生和医学研究委员会网站、加拿大安大略注册护士协会网、Cochrane Library、Joanna Briggs Institute（JBI）循证卫生保健中心数据库、护理累积索引数据库、UpToDate、BMJ best practice、Embase、PubMed、中国知网数据库、万方数据库、中国生物医学文献数据库、维普数据库关于膝关节置换术后患者出院随访的所有证据,包括指南、系统评价、证据总结、推荐实践以及随机对照试验。 结果 共纳入文献9篇,包括临床决策1篇、指南2篇、系统评价3篇、随机对照试验1篇、专家共识2篇,总结最佳证据包括随访时间和方式、身体评估、药物管理、出院康复、健康教育5个主题,共17条。 结论 本研究总结了膝关节置换术后出院随访的最佳证据,护理人员应接受相关培训,将最佳证据真正应用于临床,但在应用最佳证据时,还应考虑患者意愿和具体临床情况,结合专业判断,形成有效、可行的随访策略,从而提高护理质量。

关键词: 关节成形术, 置换, 膝, 出院后医疗, 随访, 康复护理, 循证护理学