Patients with Total joint replacement experience both physical and psychological pain before and after an operation meant to replace such joints. There is a need for clinical interventions to manage both preoperative as well as post-operative pain. The Nursing practitioner handling such patients must ensure that the pain of the patient before the operation is well managed to consequently manage post-operative pain (Petersen, 2014). Several strategies can be adopted in the managing of preoperative pain in hospital and home environments. One of these steps is educating the patient on the steps to take in managing their preoperative and consequently post-operative pain. The education process must incorporate all the steps that are critical in the management of preoperative and consequently post-operative pain as outlined in this study.
The first step in managing preoperative pain for this type of patients is the examination of their medical records and history. The medical history is critical in informing the type of intervention for preoperative pain management that can be adopted as well as the operation process itself. The examination of the medical history reveals information about prior operations and existence of chronic pains among other critical medical information (Petersen, 2014). Such information is important in determining proper ways to manage preoperative pains that are suitable for the unique circumstances of each patient. This first step of managing preoperative pain can be incorporated into patient education by helping the patient to understand why preoperative medical history examination is important to managing the pain. The patient will cooperate better if he or she is aware of the importance of the process. Moreover, this understanding will equally help the patient to cooperate with subsequent interventions that suit their unique medical history. Therefore, this education program must equip the patient as well as their caregivers on the importance of examining the medical history of the patient.
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The second step in managing preoperative pain is the Medical necessity criteria. It involves putting up records that offer necessary and reasonable support for the replacement. Such evidential may include but not limited to radiographic information, functional disabilities as well as other documented past interventions (King & Phillips, 2016). This action helps in preventing preoperative pain by helping in the identification of the major sources of pain and hence in the identification of a proper medication that can be used to manage the pain before the operation. The information further helps in guiding the operation procedure and hence enhances the probability of the operation being successful, which helps in eliminating complications that could lead to post-operative pain Deitelzweig S. (2013). It is important that the medical necessity criteria be incorporated into the patient education program. The program can incorporate this critical information by training the patients on the various preoperative tests that are required before the patient is scheduled for the operation. Moreover, the educational program should cover the importance of each of these tests about managing both pre and postoperative pain. Moreover, the educational program should help the patients understand the importance providing honest and truthful information to be included in this documentation whenever called upon to do so.
The third step relates to advising the patient to stop harmful habits such as smocking. Such habits not only enhance pain during the preoperative stage but also equally lead to postoperative complications that contribute to post-operative pain. Moreover, the habit of smoking leads to surgical cites infections after the operation and therefore enhances post-operative pain (Deitelzweig, 2013). As such, avoiding smocking at the preoperative stage is very important in managing both preoperative as well as post-operative pain. Therefore, the patient must be educated on the dangers of smoking before a complete joint replacement operation. The understanding will help the patient create the necessary commitment required to stop such habits. The step can be incorporated into the training program by explaining the various ways through which the patient can stop smoking. The training should further highlight the resources available to both the patient as well as his or her caregivers that could equally help to avoid smoking. Most importantly, the education program should help the patients understand the importance of stopping such habits. As such, the program must include the benefits of stopping such habits particularly about managing both posts as well as preoperative pain.
Fourthly, the nursing practitioner should help the patients due to a complete joint replacement surgery to carry out preoperative physical exercises. For cases of patients due for complete joint replacement surgery, Physical exercises are very critical in managing preoperative pain. Moreover, an increasing body of knowledge has confirmed a correlation between preoperative physical exercise and positive post-surgical functioning (King & Phillips, 2016). Therefore, the physical exercise helps in the alleviation of pain before and consequently after the operation. At this stage, the nursing practitioner must ensure that the patient conducts adequate and effective physical exercise that is relevant to their condition. The patient educational program should also include the aspects of physical exercise at this stage. In incorporating the aspects of physical exercise to the educational program, the nursing practitioner should explain to the patient the importance of carrying out such exercises (Holstege, Lindeboom, Lucas, 2014). Secondly, the program should explain the most appropriate forms of physical exercise that patients can carry out. Moreover, it will help the patients to confine themselves to the most efficient and relevant forms of physical exercise. Therefore, the educational presentation should include appropriate images and videos that demonstrate specific aspects of the appropriate physical exercise. Overall, it will greatly guide the patient as they undertake the physical exercise.
The next stage in managing preoperative and consequently post-operative pain is a loss of weight. The loss of one pound of weight leads to a reduction by four pounds on the pressure exerted on both the knee as well as the hip joint. Therefore, this helps to reduce post preoperative pain in such patients due to reduced pressure on the joints tremendously (Petersen, 2014). Moreover, it fosters the post-operative healing since it reduces the pressure exerted on the operation would. This way, weight loss greatly reduces both preoperative as well as post-operative pain. The management of weight loss should equally be included in the educational program. The nursing practitioner undertaking this educational program can incorporate weight loss through education of the best diet for the patients that will help them in losing weight (Holstege, Lindeboom, Lucas, 2014). The presentation should include pictures of the best foods since such would help the patients, as well as their caregivers, remember easily. Secondly, the importance of physical exercise in the process of losing weight cannot be overemphasized. Therefore, the nursing practitioner can also reemphasize physical exercise at this stage particularly about the process of losing weight (Deitelzweig, 2013). The knowledge will not only motivate the patients to attain the desired weight loss but will also teach them how to attain it.
The last stage in this process is seeking any preoperative medical help as may be required in the unique case of a patient. Although some patients might be fit to undergo a complete joint replacement Surgery, some patients may require additional preoperative medical attention. Such medical needs identified at the preoperative stage are referred to the relevant doctor or surgeon (King & Phillips, 2016). The strategy helps in managing preoperative pains and equally increases the success rate of the operation under the unique case of a particular patient. Therefore, the nursing practitioner must endeavor to identify such needs and hence management preoperative pain through clinical processes. The preoperative medical help stage should equally be incorporated into the educational program. The patient must know why it is necessary to undergo such medication and clinical process before the operations. As such, the nursing practitioner undertaking the educational program must explain to the patients this importance. He or she must further explain the specific clinical procedures that apply to each patient.
Several informatics tools can be used for presentation in the course of this educational program for preoperative pain management. These include PowerPoint, Microsoft Excel, and questionnaires. Each of these tools and databases has its strengths and weaknesses. This section discusses the strengths as well as weaknesses of the major informatics tools that can be used in the process of this educational program.
PowerPoint presentation is a useful tool for many educational programs. The major advantage of PowerPoint, particularly under this educational program, is that it can present visual and graphic images. As such, it leaves a lasting impression about the topic being taught as well as the information conveyed. In most cases, patients may not be able to understand quickly, the concepts of healthcare presented to them (Heller, Romano, Damrosch & McCarthy, 2014). However, the use of images in PowerPoint simplifies the information and makes it easy for the patient to understand. Secondly, the use of PowerPoint enables a more systematic educational program as information is presented systematically on each slide. Lastly, the PowerPoint presentation speeds up the process of learning as it allows more information to be presented compared to conventional lecture methods. The major disadvantages of PowerPoint include the fact that it aids potential neglect of interaction between the nursing practitioner and the patient. Moreover, the faster presentation through PowerPoint is likely to limit the understanding of the patients and their care.
Questionnaires are important in gathering information about the patient. The questionnaires contain specific questions that seek to interrogate the condition of the patient as well as their medical history. The major advantages of questioners are that they give the patient or their caregivers an opportunity to express themselves in regards to their specific medical condition. The information obtained directly from the patient is reliable and hence useful in making preoperative decisions (Heller, Romano, Damrosch, & McCarthy, 2014). Secondly, it takes the patient along the course of treatment. However, the use of questionnaires may not be applicable for mentally disabled patients or patients who cannot respond.
Lastly, Excel spreadsheet is equally another Microsoft database tool that can be used as an informatics tool for organizing and presenting information about the patient. The major advantage of excel is the fact that it helps in organizing patient information that is critical in making preoperative decisions and in this educational program (Heller, Romano, Damrosch & McCarthy, 2014). Excel makes it easy to track patient performance in critical preoperative aspects and consequently informs the preoperative educational program. The major limitation of excel is that it requires additional skills that an ordinary nursing practitioner may be lacking.
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In summary, the seven steps mentioned above are very critical in managing preoperative pains for patients awaiting a complete joint replacement surgery. Each of these steps must be incorporated carefully into the patient education program. Moreover, it is important to choose the most appropriate informatics tool as well as a database for use in this educational program in light of the advantages as well as limitations of each.
References
Deitelzweig S. (2013). Preventing venous thromboembolic events after total hip arthroplasty: New developments in clinical practice. Hospital Practice, 40 (2):79-87.
Heller, B. R., Romano, C. A., Damrosch, S. P., & McCarthy, M. R. (2014). The need for an educational program in nursing informatics. Nursing Informatics, 4 (2): 331-343.
Holstege MS, Lindeboom R, Lucas C. (2014). Preoperative quadriceps strength as a predictor of short-term functional outcome after total hip replacement. Archives of Physical Medicine and Rehabilitation 92 (2): 236-241.
King, A., & Phillips, J. R. (2016). Total hip and knee replacement surgery. Surgery (Oxford), 34 (9), 468-474.
Petersen, K. K. (2014). Chronic pain after total knee replacement. Chronic Pain after Total Knee Replacement, 2 (1), 1-61.
