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Yoo, Park, Chae, Lee, Shin, Ko, and Kim: Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty
Original Article

Journal of Korean Academy of Nursing 2013; 43(3): 352-360.

Published online: 28 June 2013

DOI: https://doi.org/10.4040/jkan.2013.43.3.352

Effects of ASPAN's Evidence-based Clinical Practice Guidelines for Promotion of Hypothermia of Patients with Total Knee Replacement Arthroplasty

Je Bog Yoo1, Hyun Ju Park1, Ji Yeoun Chae1, Eun Ju Lee1, Yoo Jung Shin2, Justin Sangwook Ko3, Nam Cho Kim4

1Post Anesthetic Care Unit, Samsung Medical Center, Seoul, Korea.

2Operating Room, Samsung Medical Center, Seoul, Korea.

3Department of Anesthesiology & Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

4College of Nursing, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to: Kim, Nam Cho. College of Nursing, The Catholic University of Korea, 505 Seocho-gu, Banpo-dong, Seoul 137-701, Korea. Tel: +82-2- 2258-7405, Fax: +82-2-2258-7772, kncpjo@catholic.ac.kr

Received 19 October 2012       Accepted 15 March 2013

© 2013 Korean Society of Nursing Science

Abstract

Purpose

In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia.

Methods

This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals.

Results

Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010).

Conclusion

ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

Keywords: Spinal anesthesia, Hypothermia, Body temperature, Shivering, Discomfort

Figures and Tables

Table 1
ASPAN's Evidence-Based Clinical Practice Guidelines
jkan-43-352-i001

IV=Intravenous.

Table 2
Homogeneity Test of General Characteristics between Experimental and Control Groups (N=60)
jkan-43-352-i002

Exp.=Experimental group; Cont.=Control group.

*Fisher's exact test.

Table 3
Homogeneity Test of Operation related Factors between Experimental and Control Groups (N=60)
jkan-43-352-i003

Exp.=Experimental group; Cont.=Control group.

*Fisher's exact test.

Table 4
Change of Body Temperature, Shivering, Thermal Discomfort
jkan-43-352-i004

Exp.=Experimental group; Cont.=Control group; NM=Not measured.

Table 5
Time to Achieve Normal Body Temperature (N=30)
jkan-43-352-i005

Exp.=Experimental group; Cont.=Control group.

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