Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility

Silva, Marcos Barragan da; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; Silva, Mariana Palma da; Reisderfer, Letícia

doi:10.1590/0104-1169.3526.2524

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 23 (1) • Jan-Feb 2015 • https://doi.org/10.1590/0104-1169.3526.2524 copy

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility¹ 1 Paper extracted from master´s thesis "Clinical applicability of the nursing outcomes in patients with impaired physical mobility undergoing to total hip replacement" presented to Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

AIM:

to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility

METHOD:

longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed.

RESULTS:

The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035).

CONCLUSION:

the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

Descriptors
Nursing Diagnosis; Nursing Process; Classification; Outcome Assessment (Health Care); Orthopaedic Nursing

Variable		Total n=21
Age, years*		58.8 (±16.7)
Gender, female^†		13 (61.9)
BMI (kg/m²)*		23.01 (±7.09)
Schooling, years*		8.2 (±4.1)
Caregiver presence on admission^†		17 (80.9)
Reason for surgical indication
	Osteoarthritis^†	16 (76.2)
	Dislocation^†	3 (14.2)
	Fractures^†	2 (9.5)
Primary THA^†		15 (71.4)
Performed preoperative outpatient nursing consultation^†		5 (23.8)
Received preoperative nursing home visits^†		4 (19)
Presence of pain in the hip prior to surgery^†		20 (95.2)
Suffered a fall in the previous year^†		10 (47.6)
Evaluation time, 4 days^†		15 (71.4)

Nursing Outcomes	1^st Day	2^nd Day	3^rd Day	4^th Day	p*
Nursing Outcomes	Mean (± Standard Deviation)	Mean (± Standard Deviation)	Mean (± Standard Deviation)	Mean (± Standard Deviation)	p*
Body positioning: self-initiated	2.10 (±1.47)	3.68 (±1.20)	4.23 (±1.00)	4.48 (±0.99)	<0.001
Mobility	1.00 (±0.00)	1. 40 (±1.06)	2.93 (±1.67)	3.47 (±1.36)	<0.001
Pain level	3.87 (±0.99)	4.00 (±0.93)	4.27 (±0.96)	4.20 (±1.27)	0.265
Knowledge: prescribed activity	3.12 (±0.51)	3.52 (±0.55)	3.75 (±0.39)	3.64 (±0.56)	0.035
Fall prevention behavior	2.15 (±0.72)	2.78 (±0.77)	3.29 (±0.75)	3.55 (±0.56)	<0.001

Outcomes	N	Evaluator 1	Evaluator 2	Difference (CI 95%)	p*
Outcomes	N	Mean (± Standard Deviation)	Mean (± Standard Deviation)	Difference (CI 95%)	p*
Body positioning: self-initiated	2115	1.79 (±1.33)4.48 (±0.99)	1.81 (±1.38)4.38 (±0.96)	0.02 (-0.02 - 0.07)0.10 (-0.01 - 0.21)	0.3290.082

Mobility	2115	1.00 (±0.00)3.47 (±1.36)	1.00 (±0.00)3.40 (±1.35)	0.00 (0.00 - 0.00)0.07 (-0.08 - 0.21)	1.0000.334

Pain level	2115	3.76 (±1.22)4.20 (±1.27)	3.76 (±1.22)4.13 (±1.06)	0.00 (0.00 - 0.00)0.07 (-0.19 - 0.32)	1.0000.582

Knowledge: prescribed activity	2115	3.12 (±0.53)3.64 (±0.56)	3.05 (±0.65)3.57 (±0.50)	0.07 (-0.06 - 0.21)0.07 (-0.16 - 0.31)	0.2840.515

Fall prevention behavior	2115	2.28 (±0.69)3.55 (±0.56)	2.41 (±0.89)3.58 (±0.61)	0.13 (-0.08 - 0.33)0.02 (-0.15 - 0.20)	0.2100.788

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Miriam de Abreu Almeida Rua Vicente da Fontoura, 3008/202 Bairro: Rio Branco CEP: 90640-002, Porto Alegre, RS, Brasil E-mail: miriam.abreu2@gmail.com