Programmed instruction. Patient assessment: examining joints of the upper and lower extremities.
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Biomedical subjects
Publications and source records attributed to G Viellion.
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With the advent of prospective pricing, hospitals now have a powerful incentive to improve efficiency and reduce expenses. Prospective pricing incentives are encouraging movement of preoperative teaching out of the inpatient setting. At The Center for Hip and Knee Surgery, a 24-bed research-oriented midwestern orthopaedic hospital, we have developed and implemented an alternative approach to preadmission testing and preoperative patient education.
A prospective randomized study of 300 total joint replacement patients was done comparing the gastrointestinal (GI) side effects of morphine, meperidine, and nalbuphine given by patient controlled analgesia (PCA). All three groups of patients developed some form of GI dysfunction, but no significant difference was found among the three narcotics used. It was found that normal GI assessment in the initial postoperative period does not guarantee that GI function will remain normal. This finding indicates a need for extended nursing assessment of the GI status of the postoperative PCA patient.