{"doi":"10.3389/fmed.2025.1667172","title":"Construction and application of an evidence-based prevention and management protocol for postoperative hypoxemia in elderly patients with hip fractures","abstract":"<jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>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.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      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                      <jats:italic>n</jats:italic>\n                      = 52) and June-September 2024 (post-implementation group,\n                      <jats:italic>n</jats:italic>\n                      = 52). Peripheral oxygen saturation (SpO\n                      <jats:sub>2</jats:sub>\n                      ) 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 SpO\n                      <jats:sub>2</jats:sub>\n                      changes, incidence of hypoxemia (SpO\n                      <jats:sub>2</jats:sub>\n                      &amp;lt; 90%), and healthcare professionals’ (HCPs) knowledge scores.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Repeated-measures ANOVA revealed significant main effects of time (\n                      <jats:italic>F</jats:italic>\n                      = 18.177,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) and group (\n                      <jats:italic>F</jats:italic>\n                      = 38.818,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001), as well as a significant time*group interaction (\n                      <jats:italic>F</jats:italic>\n                      = 29.865,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) on SpO\n                      <jats:sub>2</jats:sub>\n                      . Multivariate ANOVA showed significantly higher SpO\n                      <jats:sub>2</jats:sub>\n                      in the post-implementation group compared to the pre-implementation group on POD1 (\n                      <jats:italic>F</jats:italic>\n                      = 18.870,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) and POD2 (\n                      <jats:italic>F</jats:italic>\n                      = 205.270,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001). The incidence of hypoxemia was significantly reduced in the post-implementation group on POD1 (1.92% vs. 13.46%, χ\n                      <jats:sup>2</jats:sup>\n                      = 4.875,\n                      <jats:italic>p</jats:italic>\n                      = 0.027) and POD2 (0.00% vs. 19.23%, χ\n                      <jats:sup>2</jats:sup>\n                      = 11.064,\n                      <jats:italic>p</jats:italic>\n                      = 0.001). Additionally, HCPs’ knowledge scores significantly increased following protocol implementation (91.54 ± 4.90 vs. 73.08 ± 6.35,\n                      <jats:italic>t</jats:italic>\n                      = 16.59,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>\n                      The evidence-based protocol for preventing and managing postoperative hypoxemia effectively enhanced clinical decision-making, improved postoperative SpO\n                      <jats:sub>2</jats:sub>\n                      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.\n                    </jats:p>\n                  </jats:sec>","journal":"Frontiers in Medicine","year":2026,"id":644769,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":584609,"name":"Xi Chen","orcid":"0000-0002-6378-4557","position":1,"is_corresponding":false},{"id":69189,"name":"Yingqi Zhang","orcid":null,"position":2,"is_corresponding":false},{"id":1678443,"name":"Zhirong Ma","orcid":null,"position":3,"is_corresponding":false},{"id":1005190,"name":"Lili Zhao","orcid":"0000-0001-5735-7666","position":4,"is_corresponding":false},{"id":839752,"name":"Haijiao Zhang","orcid":"0000-0002-0749-9866","position":5,"is_corresponding":false},{"id":831198,"name":"Yu Zhang","orcid":"0000-0001-5969-2388","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Construction and application of an evidence-based prevention and management protocol for postoperative hypoxemia in elderly patients with hip fractures","abstract":"<jats:sec>\n                    <jats:title>Objective</jats:title>\n                    <jats:p>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.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>\n                      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                      <jats:italic>n</jats:italic>\n                      = 52) and June-September 2024 (post-implementation group,\n                      <jats:italic>n</jats:italic>\n                      = 52). Peripheral oxygen saturation (SpO\n                      <jats:sub>2</jats:sub>\n                      ) 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 SpO\n                      <jats:sub>2</jats:sub>\n                      changes, incidence of hypoxemia (SpO\n                      <jats:sub>2</jats:sub>\n                      &amp;lt; 90%), and healthcare professionals’ (HCPs) knowledge scores.\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>\n                      Repeated-measures ANOVA revealed significant main effects of time (\n                      <jats:italic>F</jats:italic>\n                      = 18.177,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) and group (\n                      <jats:italic>F</jats:italic>\n                      = 38.818,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001), as well as a significant time*group interaction (\n                      <jats:italic>F</jats:italic>\n                      = 29.865,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) on SpO\n                      <jats:sub>2</jats:sub>\n                      . Multivariate ANOVA showed significantly higher SpO\n                      <jats:sub>2</jats:sub>\n                      in the post-implementation group compared to the pre-implementation group on POD1 (\n                      <jats:italic>F</jats:italic>\n                      = 18.870,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001) and POD2 (\n                      <jats:italic>F</jats:italic>\n                      = 205.270,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001). The incidence of hypoxemia was significantly reduced in the post-implementation group on POD1 (1.92% vs. 13.46%, χ\n                      <jats:sup>2</jats:sup>\n                      = 4.875,\n                      <jats:italic>p</jats:italic>\n                      = 0.027) and POD2 (0.00% vs. 19.23%, χ\n                      <jats:sup>2</jats:sup>\n                      = 11.064,\n                      <jats:italic>p</jats:italic>\n                      = 0.001). Additionally, HCPs’ knowledge scores significantly increased following protocol implementation (91.54 ± 4.90 vs. 73.08 ± 6.35,\n                      <jats:italic>t</jats:italic>\n                      = 16.59,\n                      <jats:italic>p</jats:italic>\n                      &amp;lt; 0.001).\n                    </jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>\n                      The evidence-based protocol for preventing and managing postoperative hypoxemia effectively enhanced clinical decision-making, improved postoperative SpO\n                      <jats:sub>2</jats:sub>\n                      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.\n                    </jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41608438","pmcid":"PMC12836377","openalex_id":"https://openalex.org/W7123743760","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.04036534,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://public-pages-files-2025.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1667172/pdf","host_type":"journal"},{"url":"https://public-pages-files-2025.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1667172/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fmed.2025.1667172/full","host_type":"publisher"},{"url":"https://doi.org/10.3389/fmed.2025.1667172","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/41608438","host_type":"repository"},{"url":"https://doaj.org/article/52901287b28a40d5a91a23eab3f9f3ef","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12836377/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12836377","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12836377?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Hip and Femur Fractures","Respiratory Support and Mechanisms","Sepsis Diagnosis and Treatment"],"mesh_terms":[],"keywords":["Hypoxemia","Hip fracture","Protocol (science)","MEDLINE","Postoperative complications","Oxygen saturation","Elderly patients","Evidence-based Practice","Protocol Development","Prevention And Management"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-09T02:05:56.913018Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}