In this study, older persons and females were more
likely to need a Blood Transfusion, a finding similar
to Marcinkowski and McDonald’s (2006) report. In
fact, THR causes blood loss in patients resulting in
transfusion rates between 30–80% of cases (The Sanguis
Study Group 1994, Hasley et al. 1995). Post
operative anaemia commonly occurs (Postler et al.
2011), and other serious complications are possible.
There were four cases of anaemia and two cases of
haemorrhages in this study. So, a careful nursing
assessment and intervention related to blood loss is
required when older female persons are admitted for
THR.
Traditional CEA requires cost information for each
nursing intervention to determine their cost-effectiveness.
The challenge of getting a standardized cost per
nursing intervention is one of the reasons that more
studies have not been done examining the economics
of hospital nursing care. Despite the fact that the costs
of individual nursing interventions were not available,
path modelling enabled us to compare the costeffectiveness
of specific interventions. When two
outcomes – complication rates and hospital direct costs
– were simultaneously considered, the path coefficients
were interpreted as the ratio of changes in hospital
direct costs to changes in complication rates. These
proxy measures of CERs were presented on the costeffectiveness
plane and used to compare the cost-effectiveness
of each nursing intervention. It is of note that
the standardized direct effects estimates of nursing
interventions were used instead of their total effects to
compare cost-effectiveness of the interventions because
policy-makers, managers and administrators generally
consider an intervention individually when deciding to
either implement or exclude it. Indirect effects, which
consider all relevant causal relationships among the
interventions, cannot be easily captured in decisionmaking.
IM/SQ Administration was judged as the most costeffective
intervention. The names of medicines used by
IM/SQ Administration and relevant complications
were not available in the data set. Thus, the relationship
between this intervention and complications is
explained in only a limited way. But, IM/SQ Administration
might be cost-effective in controlling such
symptoms because the complications of this study
were inclusive of minor negative symptoms. Further
study with pharmacological information is needed to
articulate the relationship between this nursing intervention
and specific complications.