Abstract: Objective: To evaluate the application effects of the 5A nursing model in patients undergoing ambulatory total hip and knee replacement surgery, and to provide a reference for optimizing the pre-hospital management of patients undergoing day surgery. Methods: A total of 296 patients who underwent ambulatory surgery on total hip and knee joints replacement from June to November, 2023 in a general tertiary grade A hospital of Zhejiang province were grouped into control group and observation group based on the admission time. The control group received the routine management process, and the observation group set up the 5A nursing model on the basis of the routine management process. The preoperative anxiety, cancellation rate of same-day operation, hospitalization cancellation rate, the missing items rate of preoperative examination, patients' satisfaction were compared between the two groups. Results: The relief of anxiety in the observation group was better than that in control group (P<0.05). There were no significant difference in cancellation rate of same-day operation, hospitalization cancellation rate, the missing items rate of preoperative examination between the two groups (P>0.05). The average satisfaction score of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion: Pre-hospital management by applying the 5A nursing model can reduce the preoperative anxiety and improve the satisfaction of patients with total hip and knee replacement ambulatory surgery.

Key words: 5A nursing model; total hip and knee replacement; ambulatory surgery; preoperative anxiety; pre-hospital management