Evidence map›Paper›PMID 34888150›Full record

ArticleWorld journal of orthopedics2021

Implementation science for the adductor canal block: A new and adaptable methodology process.

Nikhil Crain, Chun-Yuan Qiu, Stephen Moy, Shawn Thomas, Vu Thuy Nguyen, Mijin Lee-Brown, Diana Laplace, Jennifer Naughton, John Morkos, Vimal Desai

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PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of orthopedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nikhil CrainBowman Gray Center for Medical Education, Wake Forest School of Medicine, Winston-Salem, NC 27103, United States.
Chun-Yuan QiuPerioperative Service and Anesthesiology, Kaiser Permanente Medical Center, Baldwin Park, CA 91706, United States.
Stephen MoyDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
Shawn ThomasDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
Vu Thuy NguyenDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
Mijin Lee-BrownDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
Diana LaplaceDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
Jennifer NaughtonDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States.
John MorkosJohns Hopkins University, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States.
Vimal DesaiDepartment of Anesthesiology, Baldwin Park Medical Center, Southern California Kaiser Permanente Medical Group, Baldwin Park, CA 91706, United States. vimal.desai@kp.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFollowing the successful Perioperative Surgical Home (PSH) practice for total knee arthroplasty (TKA) at our institution, the need for continuous improvement was realized, including the deimplementation of antiquated PSH elements and introduction of new practices.

aimTo investigate the transition from femoral nerve blocks (FNB) to adductor canal nerve blocks (ACB) during TKA.

methodsOur 13-month study from June 2016 to 2017 was divided into four periods: a three-month baseline (103 patients), a one-month pilot (47 patients), a three-month implementation and hardwiring period (100 patients), and a six-month evaluation period (185 patients). In total, 435 subjects were reviewed. Data within 30 postoperative days were extracted from electronic medical records, such as physical therapy results and administration of oral morphine equivalents (OME).

resultsOur institution reduced FNB application (64% to 3%) and increased ACB utilization (36% to 97%) at 10 mo. Patients in the ACB group were found to have increased ambulation on the day of surgery (4.1

conclusionBy demonstrating closure of the "knowledge to action gap" within 6 mo, our institution's findings demonstrate evidence in the value of implementation science. Physician education, technical support, and performance monitoring were deemed key facilitators of our program's success. Expanded patient populations and additional orthopedic procedures are recommended for future study.

Indexed as

Action-related information gapAdductor canal blockFemoral nerve blockOral morphine equivalentPhysical therapyTotal knee arthroplasty

Identifiers

PMID34888150
PMCPMC8613678

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.