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Effectiveness of a Nursing-Based Fast Track Surgery Protocol on Postoperative Pain Reduction: A Quasi-Experimental Study Ariani, Sri Purwanti; Yuhansyah, Yuhansyah; Ernawati, Ernawati; Jariyah, Ainun
Journal of Applied Nursing and Health Vol. 7 No. 3 (2025): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v7i3.390

Abstract

Background: Ineffective management of postoperative pain can delay recovery, increase the risk of complications, and extend the length of hospital stay. Fast Track Surgery (FTS) is a multidisciplinary approach that speeds up recovery and reduces postoperative pain effectively. However, studies on the effectiveness of nursing-based FTS interventions in regional hospitals are still limited. This study examines the effectiveness of an innovative nursing-based FTS approach in reducing pain intensity among postoperative patients. Methods: This quasi-experimental study used purposive sampling and involved 30 participants, divided into intervention and control groups. The study was conducted at TK III Dr. R. Soeharsono Hospital in Banjarmasin, South Kalimantan. Inclusion criteria were patients aged 18 to 65 years, postoperative, able to communicate well, and willing to participate. Pain intensity was measured using the Visual Analog Scale (VAS) before and two hours after the Fast Track Surgery intervention. The nursing-based FTS intervention included preoperative education, early mobilization, and multimodal analgesia management. The study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines to ensure clarity and completeness. Results: Most participants were between 19 and 44 years old, 60% were male, and the majority had completed high school. Before the intervention, patients mainly reported moderate to severe pain; after the FTS intervention, most reported mild pain. Pain intensity was significantly different between the intervention and control groups (p < 0.001). Conclusion: The nursing-based Fast Track Surgery approach effectively reduces postoperative pain intensity. It is recommended that nurse-led FTS protocols be implemented in regional hospitals to improve pain management and accelerate patient recovery.
Effectiveness of the Early Warning Score in Enhancing Nurses’ Responsiveness to Critical Patients: A Quasi-Experimental Study in the Emergency Department Ernawati, Ernawati; Ariani, Sri Purwanti; Pramunika, Pramunika
Journal of Applied Nursing and Health Vol. 7 No. 3 (2025): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v7i3.397

Abstract

Background: Emergency care services in Indonesia continue to face challenges in quickly identifying patients who are critically ill, which contributes to the high mortality rates in Emergency Departments (ED). While the Early Warning Score (EWS) has been proven effective for early detection of patient deterioration, there are limited studies on its implementation in Indonesian EDs, particularly in provincial hospitals. This highlights a gap in research that needs further attention. Methods: This study used a quasi-experimental design with a pre-test and post-test control group at Dr. H. Moch Ansari Saleh Regional General Hospital, Banjarmasin. Twenty-three ED nurses participated. We measured nurse responsiveness by examining how quickly and accurately they took clinical actions after monitoring EWS. A prototype guideline for using EWS was also developed and integrated into the hospital’s ED reporting system. The research followed CONSORT guidelines for quasi-experimental studies. Results: Most participants were female (60.9%), aged between 19 and 44 years (95.7%), with the majority holding a Diploma III in nursing (65.2%). Before introducing the EWS, 83.3% of nurses in the intervention group responded in one minute or longer, with only 25% accuracy. After the EWS implementation, 91.7% responded in under one minute, with 91.7% accuracy. In the control group, one-minute or longer response times remained high at 90.9%, and accuracy improved slightly from 18.2% to 27.3%. Statistical tests showed significant improvement in response time (p = 0.007) and accuracy (p = 0.005) in the intervention group. Conclusion: Introducing the Early Warning Score improved nurses’ responsiveness in the ED, making their clinical actions faster and more accurate. Integrating EWS into daily practice with clear guidelines can help enable timely interventions and improve patient safety during emergency care.