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
Processing time: 108 Days and 8.4 Hours
ARTICLE HIGHLIGHTS
Research background

Perioperative hypothermia (PH) has varying degrees of negative effects on the physical and mental health of patients, and there is no effective multidisciplinary team (MDT) intervention for PH in gynecological patients.

Research motivation

Despite the comprehensiveness and maturity of the practice guidelines and evidence summaries on PH prevention and management in foreign countries, there is a lack of effective clinical practice for PH in gynecological patients in China, so it is necessary to conduct this analysis to fill in this gap.

Research objectives

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

Research methods

Under the guidance of knowledge translation and combined with the opinions of stakeholders involved 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 program application.

Research results

The incidence of PH in gynecological patients decreased from 43.33% to 13.33% after the application 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 indexes were significantly improved compared with the baseline (before evidence application), with statistically significance (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 perioperative thermal comfort level of patients undergoing gynecological surgery was (27.97 ± 2.04), which was statistically increased compared with the score of (21.27 ± 1.57) investigated by researchers at baseline (P < 0.001). The perioperative Hamilton Anxiety Scale and Hamilton Depression 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.

Research conclusions

MDT-based EBP of 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.

Research perspectives

MDT-based EBP has certain effectiveness in perioperative PH prevention and management of gynecological patients and can improve patients’ psychological state and cognitive function. However, it is still necessary to solve the problem that the accuracy rate of intraoperative temperature monitoring is less than 80%.