Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Nov 19, 2023; 13(11): 848-861
Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.848
Clinical application of multidisciplinary team- and evidence-based practice project in gynecological patients with perioperative hypothermia
Qing-Yan Liu, Tong-Yang You, Dai-Ying Zhang, Juan Wang
Qing-Yan Liu, Tong-Yang You, Dai-Ying Zhang, Juan Wang, The Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Liu QY designed the study; Liu QY, You TY, Zhang DY and Wang J performed the data collection and conducted the data analysis; Liu QY wrote the manuscript; Liu QY and Wang J revised the manuscript; all authors approved the final version of the manuscript.
Institutional review board statement: The study was approved by the Institutional review board of The Affiliated Hospital of Southwest Medical University, No. KY2023184.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Juan Wang, MS, Chief Nurse, The Operating Room, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou 646000, Sichuan Province, China. wangjuan9227@163.com
Received: August 1, 2023
Peer-review started: August 1, 2023
First decision: August 16, 2023
Revised: September 4, 2023
Accepted: September 26, 2023
Article in press: September 26, 2023
Published online: November 19, 2023
Abstract
BACKGROUND

Perioperative hypothermia (PH) negatively affects the physical and mental health of patients to varying degrees. Currently, there is no effective multidisciplinary team (MDT) intervention for gynecological patients with PH.

AIM

To apply the best evidence on the prevention and management of PH in gynecological patients, improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT- and evidence-based practice (EBP) projects on the psychological status and cognitive function of gynecological patients with PH.

METHODS

Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts, the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting. Based on the evidence, the practice plan was developed, and the MDT intervention was carried out in the preoperative ward, the preoperative preparation room, the intraoperative operating room, the postanesthesia care unit, and the 24-hour postoperative gynecological ward through the EBP program. The incidence of hypothermia, the nurses’ awareness, the implementation rate of examination indicators, and the thermal comfort level, psychological status and cognitive function of patients were compared before and after the implementation of the program.

RESULTS

The incidence of PH in gynecological patients decreased from 43.33% to 13.33% after the implementation of the scheme. The implementation rate of examination indicators 6-10, 12, 14, 16-18, 21, and 22 reached 100%, and that of other indicators was above 90%, except for examination indicators 5 and 13, which was 66.67%; the indices were significantly improved compared with the baseline (before evidence application) (P < 0.05). The score of nurses' awareness of PH prevention and management in gynecological patients increased from 60.96 ± 9.70 to 88.08 ± 8.96, and the difference was statistically significant (P < 0.001). The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97 ± 2.04, which was significantly increased compared with the score of 21.27 ± 1.57 observed by researchers at baseline (P < 0.001). The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03 ± 3.16 and 13.93 ± 2.64 to 4.30 ± 1.15 and 3.53 ± 0.78, respectively, with statistically significant differences (P < 0.001). The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17 ± 1.68 to 26.93 ± 1.11, also with statistical significance (P < 0.001).

CONCLUSION

MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations, improve nurses' awareness and behavioral compliance with gynecological hypothermia management, and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’ negative emotions and enhancing their cognitive function.

Keywords: Hypothermia, Gynecology, Evidence-based care, Knowledge translation, Multidisciplinary team

Core Tip: At present, there is a lack of effective measures for perioperative hypothermia (PH) management in gynecological patients in China. This study verified the effectiveness of evidence-based practice project based on multi-disciplinary team in PH management of gynecological patients from the aspects of incidence of hypothermia, nurses' awareness, implementation rate of examination indicators, and the thermal comfort level, psychological status and cognitive function of patients.