THE EFFECT OF A NEW PERIOPERATIVE PRACTICE MODEL ON PATIENT, NURSING AND ORGANIZATIONAL OUTCOMES
Authors: Maria Pulkkinen, Nurse Manager, MNSc, PhD Candidate, Helsinki University Hospital, University of Turku; Lillemor Lindwall, Professor, University of Karlstad, Sweden; Jarkko Leskinen, MD, Helsinki University Hospital; Irma Jousela, MD, Docent, Helsinki University Hospital, University of Helsinki; Sanna Salanterä, Professor, University of Turku; Kristiina Junttila, PhD, Docent, Director of Nursing Research, Helsinki University Hospital, University of Turku
Background: Anxiety, fear and pain are known to weaken and delay patients’ recovery from surgery. In a previous pilot study, a new perioperative practice model was tested where the one and same anesthesia nurse took care of the patient during the entire perioperative process and visited the patient the next day after surgery.
Objectives: To explore the effect of a new perioperative practice model on patient outcomes (satisfaction, surgery-related anxiety, and health-related quality of life), nursing outcomes (organizational engagement) and organizational outcomes (timeline of surgical care process).
Methods: A longitudinal untreated control group design with pre- and post-tests. The randomized patient sampling (n=490) included voluntary adults undergoing hip or knee arthroplasty. Patient data collection: by 1) The Good Perioperative Nursing Care Scale 2) 15D; a generic, 15-dimensional, self-administered instrument for measuring health-related quality of life among adults and 3) STAI, State-Trait Anxiety Inventory; a definitive instrument for measuring anxiety in adults. Personnel data collection: by Nurse Engagement Survey (© Global Centre for Nursing Executives). The surgical care process data included various time stamps from the OR Management System and the Hospital Information System.
Results: 15D dimensions of moving, vitality and usual activities improved in all. The dimensions of discomfort and symptoms and distress diminished. The improvements in the intervention group were larger but not statistically significant compared to the control group. In both groups the surgery-related anxiety diminished significantly. The change was larger but not statistically significant in the intervention group. Female patients gained more from the intervention than male patients
Conclusions: The effect of the intervention could not be proved although the differences were larger in the intervention group. 
Keywords: perioperative practice model
Contact person: Maria Pulkkinen, Nurse Manager, MNSc, PhD-Candidate
Department of anesthesia and operation K, Peijas Hospital, Helsinki University Hospital,
Vantaa, Finland, +358-504272678, maria.pulkkinen@hus.fi 
