The emergence of specialist orthopaedic nurses and nurse-led pre-operative assessment in the 1990s

Nurse Practitioners in Orthopaedic Surgical Settings

“…The literature clearly identifies that a need exists for NPs in orthopaedic settings (Benham & Geier, 2014; Dower & Christian, 2009; Ho & Wilson, 2010; Horn et al, 2014; Lucas, 2009; Sebach et al, 2015; Ward et al, 2008). Across North America, patients are experiencing significant difficulty accessing physicians in specialties including gastroenterology, dermatology, and orthopaedics (Dower & Christian, 2009).…”

“…Across North America, patients are experiencing significant difficulty accessing physicians in specialties including gastroenterology, dermatology, and orthopaedics (Dower & Christian, 2009). Lack of specialty access is in part, as Lucas (2009) explains, due to changes in the healthcare system beginning in the early nineties. These changes included legislature that reduced the number of hours residents were allowed to work, which forced hospitals to investigate ways to provide the same service to patients with fewer medical staff (Benham & Geier, 2014; Lucas, 2009).…”

“…Although these healthcare changes have had some negative impacts on patient care, they have also helped pave the way for new models of care, and advanced specialty nursing positions in specialty settings (Dower & Christian, 2009; Lucas, 2009). Because of physician shortages, in the past 10 years American NPs have become an essential part of multidisciplinary orthopaedic teams, particularly in Level 1 trauma hospitals (Horn et al, 2014).…”

“…In inpatient settings, Lucas (2009) reports that orthopaedic specialist NPs are as accurate (as residents) in taking medical, surgical, and social histories, providing physical examinations, and ordering examinations when needed. More importantly, the majority of inpatient medical concerns can be addressed by the NP, and a plan of care can be initiated without the need to consult another service such as a hospitalist, which was common practice before NPs were on orthopaedic teams (Holleman et al, 2010; Horn et al, 2014).…”

“…However, changes in the healthcare system, increasing complexities in patient populations, and a reduction in resident physicians specializing in orthopaedics have resulted in the implementation of NPs in specialty roles (Sebach, Rockelli, Reddish, Jarosinski, & Dolan, 2015). According to the literature, there is an increasing need for practitioners in nontraditional specialties such as orthopaedic surgery; however, the number of NPs currently employed in orthopaedics is much lower than in primary care (Benham & Geier, 2014; Dower & Christian, 2009; Ho & Wilson, 2010; Holleman, Johnson & Frim, 2010; Horn, Badowski, & Klingele, 2014; Lucas, 2009; Sebach et al, 2015; Ward et al, 2008). Although the literature supports NPs in both primary and specialty cares (Sangster-Gormley & Canitz, 2014), this article focuses on NPs specifically in orthopaedic and surgical settings.…”