Larissa J. Teng, MN, RN, Patient Navigator, Orthopaedic Surgery, Markham Stouffville Hospital, Markham, Ontario, Canada; and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Laurie J. Goldsmith, PhD, Principal, GoldQual Consulting; and Adjunct Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Orthop Nurs. 2021;40(5):292-298. doi: 10.1097/NOR.0000000000000789.
Hip and knee replacement surgery is common, yet more than 10% of patients who undergo total hip replacement (THR) and total knee replacement (TKR) report postsurgery dissatisfaction. Recommendations for improving patient experience after total joint replacement surgery include increasing support to patients, including having a patient navigator available to patients before and after surgery. This article reports on THR and TKR patients' experiences of using an orthopaedic patient navigator. We employed qualitative description to understand THR and TKR patients' experiences of interacting with an orthopaedic patient navigator in a community teaching hospital. Telephone interviews were conducted with 15 purposefully selected total joint replacement patients (TKR: n = 11; THR: n = 4) who had at least one contact with the navigator. Interview transcripts were analyzed using thematic analysis. Patients described receiving physical support services, emotional support services, informational support services, and care coordination services from the patient navigator. All interactions with the patient navigator were positive. Knowing the patient navigator was available for any future concerns also provided indirect benefits of reassurance, comfort, and security. Patients described these direct and indirect benefits as potentially having long-lasting and resilient positive effects. An orthopaedic patient navigator can have a positive impact on patients' THR and TKR experience and fill gaps in support identified in earlier studies. Addressing patients' complex and varied care needs is well suited to a clinical nurse specialist in the role. Investing in an orthopaedic patient navigator provides reassurance to patients that their needs are a priority and will be addressed in a timely manner.
髋关节和膝关节置换手术很常见,但超过 10%接受全髋关节置换术 (THR) 和全膝关节置换术 (TKR) 的患者报告手术后不满意。改善全关节置换手术后患者体验的建议包括增加对患者的支持,包括在手术前后为患者提供患者导航员。本文报告了 THR 和 TKR 患者使用骨科患者导航员的体验。我们采用定性描述来了解社区教学医院中 THR 和 TKR 患者与骨科患者导航员互动的体验。我们对 15 名经有目的选择的全关节置换患者(TKR:n=11;THR:n=4)进行了电话访谈,这些患者至少与导航员有过一次接触。使用主题分析对访谈记录进行了分析。患者描述了从患者导航员那里获得身体支持服务、情感支持服务、信息支持服务和护理协调服务。与患者导航员的所有互动都是积极的。知道患者导航员随时可以解决任何未来的问题,也提供了间接的安心、舒适和安全。患者将这些直接和间接的好处描述为可能具有持久和有弹性的积极影响。骨科患者导航员可以对患者的 THR 和 TKR 体验产生积极影响,并填补早期研究中发现的支持差距。解决患者复杂多样的护理需求非常适合临床护士专家担任这一角色。投资于骨科患者导航员可以让患者放心,他们的需求是优先考虑的,并将及时得到解决。