Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.848
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
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.
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.
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.
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.
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.
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.
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%.