National Practice Patterns for the Care of the Patient with Total Joint Replacement

Abstract

Knowledge of national practice patterns and incorporation of the information into clinical practice can reduce the patient's risk of unsafe or ineffective care while promoting positive patient outcomes. Nurses can use these data to adjust clinical pathways and practice standards to improve patient outcomes.

Patient Dissatisfaction with Rehabilitation Following Primary Total Knee Arthroplasty

“…5 However, there is a lack of uniformity in these arthroplasty rehabilitation programs 6 with regard to the timing, setting, amount, and methods of rehabilitation. 2,7,8 The National Institute of Health conference in 2003 concluded that "… rehabilitation services are perhaps the most understudied aspect of the peri-operative management of total knee arthroplasty patients." 9…”

“…5 However, there is a lack of uniformity in these arthroplasty rehabilitation programs 6 with regard to the timing, setting, amount, and methods of rehabilitation. 2,7,8 The National Institute of Health conference in 2003 concluded that "… rehabilitation services are perhaps the most understudied aspect of the peri-operative management of total knee arthroplasty patients." 9 Keywords ► total knee arthroplasty ► rehabilitation ► patient satisfaction ► physical therapy Abstract Most patients who receive a total knee arthroplasty (TKA) undergo rehabilitation in the postoperative period.…”

Nursing Care Patterns for Patients Receiving Total Hip Replacements

“…Regarding nursing practice pattern for THR patients, Mauer et al (2002) identifi ed national nursing practice pattern via a survey with orthopaedic nurses across the country. Given a shift, a staff nurse can, therefore, care for up to three patients with THR; this calculation suggests that, on average, a nurse-to-patient staffi ng ratio of 1:3 would be desirable for this population, although different skill-mix options can dictate different staffi ng ratios.…”

“…Pain management via IV patient-controlled analgesia and IM morphine and meperidine was a focus for most of the orthopaedic nurses during the fi rst 48 hours postoperatively ( Mauer et al, 2002 ). The patients in our study also received a great deal of pain management and IM/SQ administration on the 1st and 2nd days of the hospital stay.…”

“…Perioperative assessments, education, pain management, ambulation, and rehabilitation have a signifi cant impact on treatment effectiveness and patient satisfaction (Lubbeke, Suva, Perneger, & Hoffmeyer, 2009;Mauer, Abrahams, Arslanian, Schoenly, & Taggart, 2002;O'Sullivan & Savage, 2008;Parsons & Sonnabend, 2004). Perioperative assessments, education, pain management, ambulation, and rehabilitation have a signifi cant impact on treatment effectiveness and patient satisfaction (Lubbeke, Suva, Perneger, & Hoffmeyer, 2009;Mauer, Abrahams, Arslanian, Schoenly, & Taggart, 2002;O'Sullivan & Savage, 2008;Parsons & Sonnabend, 2004).…”