Penerapan Panduan Nurse-Led Early Mobilization Pada Pasien yang Menjalani Pembedahan Elektif Tulang Belakang

Irman Irman, Rika Diah Pitaloka, Isnawan Risqi Rakhman, I Made Kariasa, Prima Agustia Nova, MG Enny Mulyatsih

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ABSTRACT

 

This study aims to determine the implementation of the Nurse-LED Early Mobilization Guide in patients undergoing elective spinal surgery. This research is an implementation of an Innovation Project which was applied to 10 respondents. Each patient in the study group was mobilized in a sequence starting from right lateral/supine/left, sitting 45o, sitting upright 90o, and dangling sitting mobilization according to the specified time. Post intervention results were evaluated where pain started from the first 24 hours (POD-1) to the third day (POD-3) while functional status after 72 hours post surgery (POD-3). Based on the results, the average Barthel Index in the post-intervention group evaluated on the third day (POD-3) was 15.30 with a standard deviation of 3.40. Meanwhile, the average pain score in the first day post-intervention group (POD-1) was 4.50 with a standard deviation of 0.97. The mean pain score on the second day (POD-2) was 3.60 with a standard deviation of 0.69. Meanwhile, the average pain score on the third day was 2.50 with a standard deviation of 0.70. Conclusion: Nurse-LED early mobilization intervention can be carried out in degenerative disc disease patients undergoing elective spine surgery to improve the patient's clinical outcomes, especially functional status and decreased pain.

 

Keywords: Decreased Pain, Functional Status, Nurse-LED Early Mobilization

 

 

ABSTRAK

 

Penelitian ini bertujuan untuk mengetahui Penerapan Panduan Nurse-LED Early Mobilization pada pasien yang Menjalani pembedahan elektif tulang belakang. Penelitian ini merupakan Penerapan Proyek Inovasi yang diterapkan pada 10 responden. Setiap pasien dalam kelompok studi dimobilisasikan dengan urutan mulai dari lateral kanan/supine/kiri, duduk 45o, duduk tegak 90o, dan mobiliasi duduk berjuntai sesuai dengan waktu yang telah ditentukan. Hasil post intervensi dievaluasi dimana nyeri mulai dari 24 jam pertama (POD-1) sampai dengan hari ketiga (POD-3) sedangkan status fungsional setelah 72 jam post operasi (POD-3).  Berdasarkan hasil bahwa rata-rata Barthel Index pada kelompok post intervensi yang dievaluasi pada hari ketiga (POD-3) adalah 15,30 dengan standar deviasi 3,40. Sedangkan rata-rata skor nyeri pada kelompok post intervensi hari pertama (POD-1) adalah 4.50 dengan standar deviasi 0.97. Mean skor nyeri pada hari kedua (POD-2) adalah 3,60 dengan standar deviasi 0,69. Sedangkan rerata skor nyeri pada hari ketiga adalah 2,50 dengan standar deviasi 0,70. Kesimpulan : intervensi Nurse-LED Early mobilization dapat dilakukan pada pasien-pasien degenerative disc disease yang menjalani pembadahan elektif tulang belakang untuk meningkatkan outcome klinis pasien khususnya adalah status fungsional dan penurunan nyeri.

 

Kata Kunci: Penurunan Nyeri, Status Fungsional, Nurse-LED Early Mobilization


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Referensi


Adogwa, O., Elsamadicy, A. A., Fialkoff, J. D., Cheng, J. S., Khalid, S. I., Karikari, I. O., & Bagley, C. A. (2017). Early Ambulation Decreases Length of Hospital Stay, Perioperative Complications, and Improves Functional Outcomes in Elderly Patients Undergoing Surgery for Correction of Adult Degenerative Scoliosis. The Spine Journal, 17(10), S111–S112. https://doi.org/10.1016/j.spinee.2017.07.182

Alshami, A. M. (2015). Prevalence of spinal disorders and their relationships with age and gender. Saudi Medical Journal, 36(6), 725–730. https://doi.org/10.15537/smj.2015.6.11095

Bielewicz, J., Kamieniak, M., Szymoniuk, M., Litak, J., Czyżewski, W., & Kamieniak, P. (2023). Diagnosis and Management of Neuropathic Pain in Spine Diseases. Journal of Clinical Medicine, 12(4), 1–26. https://doi.org/10.3390/jcm12041380

Bouhassira, D. (2019). Neuropathic pain: Definition, assessment and epidemiology. Revue Neurologique, 175(1), 16–25. https://doi.org/https://doi.org/10.1016/j.neurol.2018.09.016

Bradywood, A., Farrokhi, F., Williams, B., Kowalczyk, M., & Blackmore, C. C. (2017). Reduction of inpatient hospital length of stay in lumbar fusion patients with implementation of an evidence-based clinical care pathway. Spine, 42(3), 169–176.

Evans, L., O’Donohoe, T., Morokoff, A., & Drummond, K. (2023). The role of spinal surgery in the treatment of low back pain. Medical Journal of Australia, 218(1), 40–45. https://doi.org/10.5694/mja2.51788

Grasu, R. M., Cata, J. P., Dang, A. Q., Tatsui, C. E., Rhines, L. D., Hagan, K. B., Bhavsar, S., Raty, S. R., Arunkumar, R., Potylchansky, Y., Lipski, I., Arnold, B. A., Mchugh, T. M., Bird, J. E., Rodriguez-restrepo, A., Hernandez, M., & Popat, K. U. (2018). analysis. 29(November), 588–598. https://doi.org/10.3171/2018.4.SPINE171317.J

Hines, T. (2013). Anatomy of the Spine. In University of Cincinnati Department of Neurosurgery (pp. 1–5).

Hu, Y., McArthur, A., & Yu, Z. (2019). Early postoperative mobilization in patients undergoing abdominal surgery: A best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports, 17(12), 2591–2611. https://doi.org/10.11124/JBISRIR-D-19-00063

Huang, M., Tetreault, T. A., Vaishnav, A., York, P. J., & Staub, B. N. (2021). The current state of navigation in robotic spine surgery. Annals of Translational Medicine, 9(1), 86–86. https://doi.org/10.21037/atm-2020-ioi-07

Hudson, J. A. (2022). Early Ambulation in the post-operative orthopedic spinal patient : Does it increase functional status ?

Kiliç, E. T., Demirbilek, T., & Naderi, S. (2019). Does an enhanced recovery after surgery protocol change costs and outcomes of single-level lumbar microdiscectomy? Neurosurgical Focus, 46(4), 1–6. https://doi.org/10.3171/2019.1.FOCUS18665

Klein, K. E., Bena, J. F., Mulkey, M., & Albert, N. M. (2018). Sustainability of a nurse-driven early progressive mobility protocol and patient clinical and psychological health outcomes in a neurological intensive care unit. Intensive and Critical Care Nursing, 45, 11–17. https://doi.org/10.1016/j.iccn.2018.01.005

Kobayashi, K., Ando, K., Kato, F., Kanemura, T., Sato, K., Hachiya, Y., Matsubara, Y., Kamiya, M., Sakai, Y., Yagi, H., Shinjo, R., Nishida, Y., Ishiguro, N., & Imagama, S. (2018). Reoperation within 2 years after lumbar interbody fusion: a multicenter study. European Spine Journal, 27(8), 1972–1980. https://doi.org/10.1007/s00586-018-5508-1

Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Medical Archives (Sarajevo, Bosnia and Herzegovina), 73(6), 421–424. https://doi.org/10.5455/medarh.2019.73.421-424

Kowalski, C., Ridenour, R., McNutt, S., Ba, D., Liu, G., Bible, J., Aynardi, M., Garner, M., Leslie, D., & Dhawan, A. (2021). Risk Factors For Prolonged Opioid Use After Spine Surgery. Global Spine Journal, 13(3), 683–688. https://doi.org/10.1177/21925682211003854

Krupp, A., Steege, L., & King, B. (2018). A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit. Intensive and Critical Care Nursing, 47, 30–38. https://doi.org/10.1016/j.iccn.2018.04.003

Li, J., Li, H., Xv, Z. K., Wang, J., Yu, Q. F., Chen, G., Li, F. C., Ren, Y., & Chen, Q. X. (2018). Enhanced recovery care versus traditional care following laminoplasty: A retrospective case-cohort study. Medicine (United States), 97(48). https://doi.org/10.1097/MD.0000000000013195

Li, Z., Zhang, X., Wang, K., & Wen, J. (2018). Effects of Early Mobilization after Acute Stroke: A Meta-Analysis of Randomized Control Trials. Journal of Stroke and Cerebrovascular Diseases, 27(5), 1326–1337. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.021

Licina, A., Silvers, A., Laughlin, H., Russell, J., & Wan, C. (2021). Pathway for enhanced recovery after spinal surgery-a systematic review of evidence for use of individual components. BMC Anesthesiology, 21(1), 1–21. https://doi.org/10.1186/s12871-021-01281-1

Lonser, R. R., Zipfel, G. J., & Antonio Chiocca, E. (2020). National Institute of Neurological Disorders and Stroke: current funding status, opportunities, challenges, emerging scientific advances, and recommendations for neurosurgery. Journal of Neurosurgery, 133(4), 1264–1269. https://doi.org/10.3171/2020.4.JNS201202

Ma, H., Hai, B., Yan, M., Liu, X., & Zhu, B. (2021). Evaluation of Effectiveness of Treatment Strategies for Degenerative Lumbar Spinal Stenosis: A Systematic Review and Network Meta-Analysis of Clinical Studies. World Neurosurgery, 152, 95–106. https://doi.org/10.1016/j.wneu.2021.06.016

Mobbs, R. J. (2020). Gait velocity (walking speed) is an indicator of spine health, and objective measure of pre and post intervention recovery for spine care providers. Journal of Spine Surgery, 6(2), 353. https://doi.org/10.21037/JSS-20-602

Qvarfordh, P., Olsen, K. S., Bendix, T., & Esbensen, B. A. (2014). Should patients walk from the postanesthesia care unit to the general ward after a lumbar discectomy? A randomized study. Journal of Perianesthesia Nursing, 29(5), 377–384. https://doi.org/10.1016/j.jopan.2013.10.006

Ramba, H. La, Yari, Y., Idris, I., Junaiddin, J., Irman, I., & Amir, H. (2022). The Effect of Aromatherapy Administration in the Decrease of Nausea in Post-Spinal Anesthesia Patients. Open Access Macedonian Journal of Medical Sciences, 10(F), 314–318. https://doi.org/10.3889/OAMJMS.2022.8904

Ravindra, V. M., Senglaub, S. S., Rattani, A., Dewan, M. C., Härtl, R., Bisson, E., Park, K. B., & Shrime, M. G. (2018). Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume. Global Spine Journal, 8(8), 784–794. https://doi.org/10.1177/2192568218770769

Rupich, K., Missimer, E., O’Brien, D., Shafer, G., Wilensky, E. M., Pierce, J. T., Kerr, M., Kallan, M. J., Dolce, D., & Welch, W. C. (2018). The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients. American Journal of Nursing, 118(6), 46–53. https://doi.org/10.1097/01.NAJ.0000534851.58255.41

Sepulveda-Pacsi, A. L., Soderman, M., & Kertesz, L. (2016). Nurses’ perceptions of their knowledge and barriers to ambulating hospitalized patients in acute settings. Applied Nursing Research, 32, 117–121. https://doi.org/10.1016/j.apnr.2016.06.001

Shields, L., Clark, L., Glassman, S., & Shields, C. (2017). Decreasing hospital length of stay following lumbar fusion utilizing multidisciplinary committee meetings involving surgeons and other caretakers. Surgical Neurology International, 8(1). https://doi.org/10.4103/2152-7806.198732

Yoo, J. S., Ahn, J., Buvanendran, A., & Singh, K. (2019). Multimodal analgesia in pain management after spine surgery. Journal of Spine Surgery, 5(13), 154–159. https://doi.org/10.21037/jss.2019.05.04




DOI: https://doi.org/10.33024/mahesa.v4i9.14889

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