{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:23:14Z","timestamp":1783009394937,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"\n Objective<\/jats:title>\n To assess the effectiveness of operating room nursing pathways based on the nine-grid thinking model in older adults undergoing total knee arthroplasty (TKA).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 110 older adults scheduled for TKA were randomly assigned to either a control group, which received conventional operating room nursing, or a intervention group, which received nursing care guided by the nine-grid thinking model. Key outcomes included surgical efficiency, nursing quality, satisfaction among patients and physicians, incidence of complications, and rehabilitation outcomes were compared between the two groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The intervention group had significantly shorter surgical prep (t = 9.106), operative (t = 5.294), and turnover times (t = 14.110) than controls (\n p<\/jats:italic>\n < 0.05). After the intervention, the intervention group scored higher on sterile technique (t = 21.850) and overall nursing performance (t = 12.440). Their nurses also reported greater satisfaction with admission education (t = 8.591), positioning (t = 11.940), and overall care (t = 7.182) (\n p<\/jats:italic>\n < 0.05). Surgeons rated the intervention group higher for instrument prep (t = 9.629), intraoperative coordination (t = 13.860), instrument delivery (t = 11.490), and overall satisfaction (t = 16.670) (\n p<\/jats:italic>\n < 0.05). Deep-vein-thrombosis incidence was lower (\u03c72 = 4.949), postoperative pain scores were lower (t = 39.980), and ambulation and functional-recovery scores were higher in the intervention group (all\n p<\/jats:italic>\n < 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The application of the nine-grid thinking model significantly enhanced the quality and efficiency of perioperative care for older adults undergoing TKA.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10225536261459490","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T09:12:25Z","timestamp":1782810745000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of a nine-grid thinking model to optimize operating room nursing pathways for older adults undergoing total knee arthroplasty"],"prefix":"10.1177","volume":"34","author":[{"given":"Yuquan","family":"Tian","sequence":"first","affiliation":[{"name":"Jinzhou Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Qi","sequence":"additional","affiliation":[{"name":"Shandong University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[{"name":"Shandong University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8462-6489","authenticated-orcid":false,"given":"Huijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jinzhou Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04348-6"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/os.13780"},{"issue":"1","key":"e_1_3_6_4_2","first-page":"119","article-title":"Import and analysis of multicenter randomized controlled clinical trial data for total knee arthroplasty based on the REDCap system","volume":"52","author":"Liu Y","year":"2025","unstructured":"Liu Y, Cao PH, Ding CH. Import and analysis of multicenter randomized controlled clinical trial data for total knee arthroplasty based on the REDCap system. Fudan University Journal (Medical Sciences) 2025; 52(1): 119\u2013127. https:\/\/www.cqvip.com\/doc\/journal\/7200047840?sign=e8f1a556acc3eb88ac2522147c4fb5840b0dff52d107ebabe53e5c12aaf1a175&expireTime=1797486519390&resourceId=7200047840","journal-title":"Fudan University Journal (Medical Sciences)"},{"issue":"2","key":"e_1_3_6_5_2","first-page":"362","article-title":"Compliance with postoperative rehabilitation exercise and its associated factors and intervention strategies in elderly patients after knee arthroplasty","volume":"44","author":"Wu XT","year":"2025","unstructured":"Wu XT, Li MF, Shi JJ, et al. Compliance with postoperative rehabilitation exercise and its associated factors and intervention strategies in elderly patients after knee arthroplasty. 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Nurs Res 2024; 38(15): 1348\u20131354. https:\/\/www.cqvip.com\/doc\/journal\/7112681005?sign=525e9695b8cc6c64db04396466dea4b79e113bb0a847353b9a94cffe6ae19e66&expireTime=1797486570337&resourceId=7112681005","journal-title":"Nurs Res"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-08263-7"},{"issue":"1","key":"e_1_3_6_8_2","first-page":"88","article-title":"Development of a home-based rehabilitation exercise program for patients after total knee arthroplasty","volume":"39","author":"Chen R","year":"2024","unstructured":"Chen R, Shi CX, Shan YW, et al. Development of a home-based rehabilitation exercise program for patients after total knee arthroplasty. Journal of Nursing Science 2024; 39(1): 88\u201392. 115. https:\/\/www.cqvip.com\/doc\/journal\/7111528217?sign=8f995d2da2f89672c303fc6f7ac89fa55787c81f8b79f907dcd08b2c3338a287&expireTime=1797486602532&resourceId=7111528217","journal-title":"Journal of Nursing Science"},{"issue":"12","key":"e_1_3_6_9_2","first-page":"1088","article-title":"Risk factors for prolonged hospital stay in patients undergoing primary total knee arthroplasty under enhanced recovery after surgery protocols","volume":"17","author":"Wei CB","year":"2024","unstructured":"Wei CB, Gu SJ, Liu Y, et al. Risk factors for prolonged hospital stay in patients undergoing primary total knee arthroplasty under enhanced recovery after surgery protocols. Chinese Journal of Bone and Joint Surgery 2024; 17(12): 1088\u20131093. https:\/\/www.cqvip.com\/doc\/journal\/7113553460?sign=b45e8d012613b8c8c5c4466c07df6249d423827d50fd8a32d6a9a883bdb19690&expireTime=1797486631169&resourceId=7113553460","journal-title":"Chinese Journal of Bone and Joint Surgery"},{"issue":"10","key":"e_1_3_6_10_2","first-page":"139","article-title":"Impact of root-cause-analysis-guided predictive nursing on postoperative quality of life in patients undergoing unilateral knee arthroplasty","volume":"21","author":"Fan JJ","year":"2024","unstructured":"Fan JJ, Xie J, Chen Y, et al. Impact of root-cause-analysis-guided predictive nursing on postoperative quality of life in patients undergoing unilateral knee arthroplasty. China Medical Herald 2024; 21(10): 139\u2013142. https:\/\/www.cqvip.com\/doc\/journal\/7112254344?sign=66e96574205d430668aee749f2f12054a0dfcbe04d3476a7a0059f2db88c4c3a&expireTime=1797486669259&resourceId=7112254344","journal-title":"China Medical Herald"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v11.i32.7745"},{"issue":"5","key":"e_1_3_6_12_2","first-page":"825","article-title":"Systematic operating-room nursing cooperation measures and their effectiveness in robot-assisted total knee arthroplasty","volume":"5","author":"Yang M","year":"2024","unstructured":"Yang M, Zhang W, Zheng J. Systematic operating-room nursing cooperation measures and their effectiveness in robot-assisted total knee arthroplasty. 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