Perioperative nursing care protocol in geriatric knee surgery
DOI:
https://doi.org/10.62452/f091t247Keywords:
Perioperative care, geriatric nursing, knee surgery, clinical protocol, Ecuadorian contextAbstract
The need to develop a nursing care protocol adapted to the Ecuadorian context was identified, aiming to optimize care throughout the three phases of the perioperative period in knee surgeries for older adults. The objective was to standardize nursing interventions, strengthen the professional role, and promote safer, more humane, and effective patient care. To achieve this, a systematic review of scientific literature published between January and March 2024 was conducted, using recognized academic databases and applying rigorous methodological criteria. A descriptive-comparative qualitative approach with a non-experimental design was employed, based on documentary analysis. The findings revealed distinct care practices for each perioperative phase, highlighting educational, psycho-emotional, and clinical interventions in the preoperative stage; preventive measures against intraoperative complications; and multimodal strategies for postoperative pain management and recovery. The information was systematized using the NANDA diagnostic classification, NOC expected outcomes, and NIC interventions. Based on this evidence, a context-specific protocol was proposed to enhance the quality of nursing care for geriatric patients undergoing knee surgery. The study provided a practical, evidence-based tool tailored to the characteristics of the Ecuadorian healthcare system.
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Aguilar Torres, L., & Plata Delgado, B. L. (2024). Las actividades de enfermería en el transoperatorio en correlación con la incidencia de infección de la artroplastía de la rodilla y de la cadera. Revista Sanidad Militar, 53(4). https://revistasanidadmilitar.org/index.php/rsm/article/view/1327
Álvarez Pelegino, A., Miguel Vázquez, Y., Aguirre Raya, D. A., & Garzón Patterson, M. (2022). Intervención de enfermería para disminuir la ansiedad en el perioperatorio en cirugía cardiovascular. Revista Cubana de Angiología y Cirugía Vascular, 23(2). http://scielo.sld.cu/pdf/ang/v23n2/1682-0037-ang-23-02-e362.pdf
Aranzamendi Antaurco, T. R. (2024). Efectividad de la evaluación preoperatoria de enfermería en la ansiedad del paciente quirúrgico [Tesis de grado, Universidad Peruana Cayetano Heredia].
Barreiro Espinoza, M. A., Salazar Martínez, E. O., Tirado Velastegui, R., & Toctaguano Sailema, V. M. (2023). Optimización de la gestión del cuidado de enfermería en el perioperatorio de cirugías ortopédicas y traumatológicas: una revisión bibliográfica. Dominio de las Ciencias, 9(4), 1083–1096. https://doi.org/10.23857/dc.v9i4.3639
Chaparro, J., & Oñate, M. (2021). Prevención de lesiones por presión en pacientes sometidos a cirugía traumatológica prolongada, un desafío para enfermería. Revista Médica Clínica Las Condes, 32(5), 617–623. https://doi.org/10.1016/j.rmclc.2021.09.006
Inurria Salcedo, R., Romero-Serrano, R., & Perejón Martín, E. (2021). Protocolo fast-track en artroplastia de rodilla. Evidentia, 18, e13024. https://ciberindex.com/c/ev/e13024
Jiménez Mata, G. M., & Navarro Elizondo, E. F. (2021). Plan de cuidados a usuarios en etapa preoperatoria en un hospital privado: Estudio de caso [Tesis de grado, Universidad de Costa Rica].
Leal Gómez, R. F., Reyes Pedroza, J. A., Castillo Álvarez, A., Armería Vigna, J. A., Archundia Nájera, S., & Wong Serrano, M. (2020). Práctica médica en cirugía de rodilla ante la pandemia COVID-19. Orthotips AMOT, 16(3), 126–130. https://doi.org/10.35366/94525
Li, L., Pan, H., Liu, G., Wang, F., Zheng, S., & Wang, J. (2023). Value of tranexamic acid and progressive nursing in accelerating postoperative rehabilitation after total knee arthroplasty. Alternative Therapies in Health and Medicine, 29(1). https://pubmed.ncbi.nlm.nih.gov/35951070/
Liao, X., & Xu, X. (2022). The effect of cold therapy combined with ERAS in the postoperative care of patients undergoing total knee arthroplasty. American Journal of Translational Research, 14(5), 3154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9185063/
Malier, S., & Slullitel, D. (2021). Reconstrucción todo-adentro en lesiones aisladas del ligamento cruzado posterior: Técnica quirúrgica y resultados clínicos. RELART| Revista Latinoamericana de Artroscopia, Reconstrucción Articular y Trauma Deportivo, 28(2). https://pesquisa.bvsalud.org/gim/resource/enauMartinsNetoViviana/biblio-1282679
Medina-Garzón, M., & Navarro-Córdoba, J. R. (2024). Autoeficacia en pacientes programados para cirugía de reemplazo de rodilla: Ensayo clínico controlado. Revista de la Universidad Industrial de Santander Salud, 56. https://doi.org/10.18273/saluduis.56.e:24032
Merino Ruiz, R., García Moreno, A. M., & Velasco Molina, N. (2018). Plan de cuidados intraoperatorios estandarizado para pacientes intervenidos de artroplastia total de rodilla. Paraninfo Digital, 12(28), e079. Fundación Index. http://www.index-f.com/para/n28/e079.php
Migliorini, F., Eschweiler, J., Baroncini, A., Tingart, M., & Maffulli, N. (2021). Better outcomes after minimally invasive surgeries compared to the standard invasive medial parapatellar approach for total knee arthroplasty: A meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 29(11), 3608–3620. https://doi.org/10.1007/s00167-020-06306-9
Nashwan, A. J. (2024). Optimizing pain management in elderly patients post-knee surgery: A novel collaborative strategy. World Journal of Clinical Cases, 12(15), 2475. https://doi.org/10.12998/wjcc.v12.i15.2475
Orellana Cifuentes, J., Pedrera Quezada, N., Jima Blacio, J., Sanmartin Pineda, M., Jimenez Soto, R., Macas González, L., Porras Ibáñez, H., Cañafe Carpio, C., Fernández Maldonado, D., & Saraguro Calberto, E. (2025). Determinantes Sociales y Prevalencia de Enfermedades en Adultos Mayores de Asilos en Ecuador. Polo del Conocimiento, 10(1), 645-668. https://doi.org/10.23857/pc.v10i1.8700
Oteo Álvaro, Á. (2021). Mecanismos etiopatogénicos de la artrosis. Revista de la Sociedad Española del Dolor, 28, 11–17. https://dx.doi.org/10.20986/resed.2021.3851/2020
Riscanevo-Bobadilla, C., Barbosa, R. E., Guerrero, I. M., Valbuena, D., Naranjo, M. P., Hernández, M., Cuello, L., Chona, M., Velandia, A., & Martin, W. (2024). Protocolo de recuperación mejorada después de cirugía (ERAS) atenúa el estrés y acelera la recuperación en pacientes después de resección radical por cáncer colorrectal: Experiencia en la Clínica Universitaria Colombia. Revista Colombiana de Cirugía, 39(2), 218–230. https://doi.org/10.30944/20117582.2831
Valenzuela Bacilio, C. M. (2024). Tendencias sobre las estrategias del profesional de enfermería para disminuir la ansiedad en pacientes quirúrgicos [Tesis de grado, Universidad Peruana Cayetano Heredia].
Vílchez-Cavazos, F., Peña-Martínez, V. M., & Arrambide-Garza, F. J. (2024). Optimizando la artroplastia total de rodilla: El impacto del ácido tranexámico. Orthotips AMOT, 20(2), 129–135. https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=115657
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Copyright (c) 2025 Gerardo Ramos-Serpa, Leonardo Sebastián Pilamunga-Guamán, Nairovys Gómez-Martínez (Autor/a)

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