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Updated: Jan 30, 2026
Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017
Construction and application of an evidence-based prevention and management protocol for postoperative hypoxemia in
Yu Zhang1, Xi Chen1, Yingqi Zhang1
1Department of Orthopedic Surgery, People's Hospital of Ningxia Hui Autonomous Region (People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University), Yinchuan, China.
Objective:
To develop an evidence-based practice protocol for the prevention and management of postoperative hypoxemia in elderly patients with hip fracture and to evaluate its clinical effectiveness.
Methods:
Utilizing evidence-based nursing methodology, we systematically retrieved, appraised, and synthesized the best available evidence regarding the prevention and management of postoperative hypoxemia in this patient population. Guided by a knowledge translation framework, an evidence-based practice protocol was developed. Elderly hip fracture patients undergoing surgery at a tertiary hospital in Ningxia were enrolled from January-April 2024 (baseline/pre-implementation group, n = 52) and June-September 2024 (post-implementation group, n = 52). Peripheral oxygen saturation (SpO2) was measured at key time points: upon entering the operating room, upon returning to the ward, and on postoperative days (POD) (1) and (2). Comparisons were made between groups regarding SpO2 changes, incidence of hypoxemia (SpO2 < 90%), and healthcare professionals' (HCPs) knowledge scores.
Results:
Repeated-measures ANOVA revealed significant main effects of time (F = 18.177, p < 0.001) and group (F = 38.818, p < 0.001), as well as a significant time*group interaction (F = 29.865, p < 0.001) on SpO2. Multivariate ANOVA showed significantly higher SpO2 in the post-implementation group compared to the pre-implementation group on POD1 (F = 18.870, p < 0.001) and POD2 (F = 205.270, p < 0.001). The incidence of hypoxemia was significantly reduced in the post-implementation group on POD1 (1.92% vs. 13.46%, χ2 = 4.875, p = 0.027) and POD2 (0.00% vs. 19.23%, χ2 = 11.064, p = 0.001). Additionally, HCPs' knowledge scores significantly increased following protocol implementation (91.54 ± 4.90 vs. 73.08 ± 6.35, t = 16.59, p < 0.001).
Conclusion:
The evidence-based protocol for preventing and managing postoperative hypoxemia effectively enhanced clinical decision-making, improved postoperative SpO2 levels, reduced hypoxemia incidence, and enhanced HCPs' knowledge. These findings support the protocol's feasibility and effectiveness for clinical implementation in elderly hip fracture patients.
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