Construction Of Evidence-based Nursing For Pain Assessment Of Patients Undergoing Total Hip Replacement

Objective:(1)Systematic search and evaluation of clinical practice guidelines for pain assessment in patients undergoing total hip replacement to obtain high-quality guidelines as the basis for evidence-based practice;(2)Extract the recommendations for total hip replacement pain assessment suitable for China's national conditions from high-quality guidelines;(3)By understanding the current status of the recommendation recommendations for total hip replacement pain assessment in the pilot department,clarify the gap between the clinical status and the best recommendation to determine the practical plan to be carried out in the pilot department in the next year;(4)By investigating the obstacles in the clinical application process of the appropriate implementation of the practical program,and formulating the corresponding action strategy,the localized evidence-based nursing practice program for pain assessment of patients with total hip replacement is finally constructed.Methods:(1)Using the literature review method,systematically search for 13 domestic and foreign hip professional website sites such as the American Association of Hip and Knee Surgeons(AAHKS),8 guide sites such as the Scottish Intercollegiate Guide Network(SIGN),and 5 databases such as CNKI database,searched from December to December 2019,including the latest version of the Chinese and English guidelines including total hip replacement pain assessment,and handed over to three researchersusing AGREE ? evaluation tools to evaluate the quality of the guidelines,so as to select high Quality guidelines(2)The two researchers extracted the recommendations from the high-quality guidelines and gave them to the third researcher for translation.The Chinese and English recommendation opinions are made into the best recommendation opinion review table,and the expert meeting method is used for proofreading to form the Chinese version of the recommendation opinions.The researchers classified the recommended opinions into subject categories and synthesized the contents,developed a comprehensive evaluation form of the best recommended opinions for total hip replacement pain assessment,and conducted an investigation using an expert meeting method.The evaluation form includes the classification of recommendations and comprehensive rationality judgments,as well as the selection of recommendations for orthopedic nursing in line with China's national conditions,and finally forms the best recommendations for pain assessment of patients with total hip replacement suitable for China's national conditions;(3)Researchers formulate the best recommendations for pain assessment of patients with total hip replacement suitable for China's national conditions into the best recommendation applicability evaluation form,and use the expert meeting method to conduct the evaluation table survey to select the pilot departments in the next year and the recommendations that are suitable for development are used as practical solutions;(4)The researchers formulate questionnaires on the obstacles and action strategies for the implementation of the practical plan,and use the expert meeting method to investigate.After summarizing the action strategy,the research team formulated the content based on the action strategy,and again used the expert meeting method to evaluate the formulation content,and finally completed the localized evidence-based nursing practice plan for pain assessment of patients with total hip replacement.Results:(1)A total of 8 clinical practice guidelines were included in this study.After evaluation using the AGREE II tool,the quality of 5 guidelines was grade A and the quality of 3 guidelines was grade B.(2)A total of 28 recommendations on pain assessment of patients undergoing total hip arthroplasty were extracted from 8 high-quality guidelines.Ten experts wereinvited to review Chinese translations using the expert meeting method.The expert authority coefficient was 0.815.The argumentation results were reliable and the Chinese version was finally obtained.Recommendations.Once again,10 experts were invited to fill in the comprehensive evaluation form of the best recommendations for pain assessment in patients undergoing total hip replacement.The expert authority coefficient is 0.855,and the results are reliable.After the steps of translation,proofreading,integration,and expert verification,we finally obtained 14 recommendations in line with my country's national conditions.(3)15 experts were invited to evaluate the clinical applicability of 14 recommendations.The expert authority coefficient was 0.827.The result of the demonstration was 4 recommendations.The clinical development status of the recommendations is good.1 recommendation was rejected due to the insufficient number of patients in the clinical trial department.The 9 recommendations have to be improved in clinical development,and the current pilot departments meet the conditions for implementing the recommendations,so the final 9 recommendations are included in the pilot departments for implementation.(4)Through systematic investigation of the obstacles to the clinical implementation of the recommended opinions,it proposed action strategies such as the development of pain assessment nursing record sheets and assessment flowcharts,the provision of pain assessment tools,and the development of nurses 'pain assessment training content.The research team formulated pain assessment nursing records based on expert opinions List,evaluation flow chart,nurse training catalog,etc.Fifteen experts were invited to evaluate the content of the practice plan.The authoritative coefficient of the expert was 0.853.The research team further revised and improved it,and finally completed the construction of the pain assessment nursing record sheet,assessment flowchart,and nurse training catalog.Implementation approach of evidence-based nursing practice for pain assessment of patients undergoing total hip replacement.Conclusions:At present,there are problems in the development of clinical practice.There is a certain gap between the recommendation and clinical practice,and the transformation of recommendation in the clinic is accelerated.Based on the evidence-based method,the best recommendation opinion,clinical status,and nurse experience combined to form a total hip replacement pain assessment evidence-based nursing practiceprogram can effectively solve clinical problems,improve clinical nursing quality,and effectively manage patient pain.