Implementation of a nine-grid thinking model to optimize operating room nursing pathways for older adults undergoing...

ObjectiveTo assess the effectiveness of operating room nursing pathways based on the nine-grid thinking model in older adults undergoing total knee arthroplasty (TKA).Methods110 older adults scheduled for TKA were randomly assigned to either a control group, which received conventional operating room nursing, or a intervention group, which received nursing care guided by the nine-grid thinking model. Key outcomes included surgical efficiency, nursing quality, satisfaction among patients and physicians, incidence of complications, and rehabilitation outcomes were compared between the two groups.ResultsThe intervention group had significantly shorter surgical prep (t = 9.106), operative (t = 5.294), and turnover times (t = 14.110) than controls (p < 0.05). After the intervention, the intervention group scored higher on sterile technique (t = 21.850) and overall nursing performance (t = 12.440). Their nurses also reported greater satisfaction with admission education (t = 8.591), positioning (t = 11.940), and overall care (t = 7.182) (p < 0.05). Surgeons rated the intervention group higher for instrument prep (t = 9.629), intraoperative coordination (t = 13.860), instrument delivery (t = 11.490), and overall satisfaction (t = 16.670) (p < 0.05). Deep-vein-thrombosis incidence was lower (χ2 = 4.949), postoperative pain scores were lower (t = 39.980), and ambulation and functional-recovery scores were higher in the intervention group (all p < 0.05).ConclusionThe application of the nine-grid thinking model significantly enhanced the quality and efficiency of perioperative care for older adults undergoing TKA.