ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicPerioperative Management and Clinical Challenges in Elderly Major Surgical PatientsView all 9 articles
Construction and Application of an Evidence-Based Prevention and Management Protocol for Postoperative Hypoxemia in Elderly Patients with Hip Fractures
Provisionally accepted
- 1Ningxia Clinical Research Institute,People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China, 750002, Yinchuan, China
- 2People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
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 incresed 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.
Keywords: Hip fracture, hypoxemia, Prevention and management, Evidence-Based Practice, protocol development, Postoperative Complications, elderly patients, oxygen saturation
Received: 09 Sep 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Zhang, Chen, Zhang, Ma and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haijiao Zhang, 1145082458@qq.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.