What Are the Effective Ways of Managing Post-Operative Complications among Patients - Literature review Example

Introduction The essay focuses on management of post-operative issues among respective patients. Article one concerns urinary retention as a post-operative problem for women who have gone through urogynecologic surgery. Bladder distention could cause impaired bladder function, disrupted surgical repair, impaired surgical results, and urinary infections. In article two, injuries to the knee menisci are a normal cause of functional disability and impairment. Its prevalence is between 19 and 56% depending upon population under study. The study was meant to determine the effectiveness of rehabilitation in improving function and reducing impairments. Finally, the third article concerns post-operative evaluations in a surgical High-Dependency Unit (HDU). It relates to the Scottish Intercollegiate Guideline Network (SIGN) that was documented in 2004 to advocate for post-operative assessments in optimizing post-operative care. In this case, a clinical question which is the research question is effective ways of administering post-operative care. PICO framework (Patient/Population; Intervention; Comparison Intervention if appropriate; Outcome) is used to analyse the articles. The three articles were obtained from EBSCO HOST library and Mosby’s Nursing Consult (University of Wollongong). The searches terms that were used includes ‘operative care’ and ‘post care’ or ‘post operative care’. Other English articles were also included in the search. The page limit was restricted to from 2000 to 2014; this ensured that the articles obtained were recent. Since the research in EBSCO HOST library and Mosby’s Nursing consult gave only gave journals and other descriptive articles, descriptive articles were selected only. In EBSCO HOST, the search results were 323,484 and in Mosby’s Nursing Consult, the results were 2179, only relevant articles were selected. Research question- what are the effective ways of managing post-operative complications among patients? This question will be analyzed using PICO framework as follows: P-post-operation male and female patients I- post operative complications C- Risk versus effectiveness O- Post-surgery impairments or poor functioning Three articles will be used as outlined below: Article one Buchko, B.L., Robinson, L.E., & Bell, T.D. (2013). Translating an evidence-based algorithm to decrease early post-operative urinary retention after urogynecologic surgery. Urologic Nursing, 33(1), 24-28, 32. Overview The study involved was a randomized test with two groups; a control and intervention groups that were treated equally to boost accuracy of the outcomes. The comparison groups were also blinded to enhance accuracy of study findings. The aim of the study is to establish whether an evidence-based algorithm in managing post-operative urinary retention in women who had gone through urogynecologic surgery would avoid urinary retention and enhance voiding efficiency. Critical appraisal Recruitment The sample data was obtained through a retrospective chart review. The method used to enroll subjects included those women that had gone through urogynecologic surgery in the period from August 2005 and December 2006, and include vaginal hysterectomy, posterior and anterior colporrhaphy, Burch or Marshall-Marchetti-Krantz procedure, and suburethral sling. This also included surgery done by a gynecologist; women under care on post-partum-gynecologic unit upon transfer from post-anesthesia care unit. Those excluded from the study were women from whose surgery was done by surgeons apart from gynecologists and who were under care in another unit apart from postpartum-gynecologic unit (Buchko, Robinson & Bell 2013). Allocation/adjustment According to Buchko, Robinson and Bell (2013), using a designed evidence-based algorithm, patients were put into two categories as per whether they receieved post or pre-implementation care. The research team also calculated a priori power analysis using G* Power 3.1.2 computer application for an independent t-test by use of parameters for a 2-tailed test, expecting a medium outcome, with 0.05 alpha and power of 0.80. Each group required a minimum of 64 trials for an optimal 128 sum sample size. Some of the data collected included time and date of insertion of indwelling urethral catheter; time and date of insertion of indwelling urethral catheter; time, date, and amount of every measured void; time, date and volume of bladder ultrasound evaluation of bladder volume either if the patient incapable of void or as PVR; as well as time, date, and amount of recurrent catheterization when needed by algorithm points of decision (Buchko et al., 2007). Maintenance The pre-intervention and post-intervention categories were unequal; hence the nonparametric optional to the independent samples the Mann-Whitney U, and t-test was utilized in assessing the variance between categories for continuous variables. Both groups were also analyzed as per their allocations. This is a vital fact as studies indicate that such a measure enhances a study’s accuracy (Fedorkow, Dore & Cotton 2005). Measurement Fisher’s precise tests of Chi-square test were employed in testing for the importance of categorical variables. Statistical significance was noted as p Read More