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Session Details

Standardizing Discharge Education for Ambulatory Total Joint Patients

Track: Podium: Clinical Practice

Session Number: S406
Date: Tue, Jun 2nd, 2020
Time: 12:30 PM - 1:30 PM

Description:

To initiate the quality improvement (QI) process, thirty-three staff nurses in the PACU completed a pre-survey consisting of nine questions to assess their knowledge of the ambulatory joint patient discharge process as well as accessibility to educational resources. According to the survey, 72% of nurses had participated in the discharge of an ambulatory joint patient however 50% of nurses strongly agreed that they did not have sufficient input into the program of care for these patients. The results of the survey also strongly supported that the nurse-patient relationship suffers when appropriate discharge resources are not available. These survey results strongly indicated a need to strengthen interdisciplinary communication and collaboration within the microsystem. Project planning and implementation were based on the PDSA cycle developed to complete this QI project. The PDSA cycle offers a disciplined model to test improvements based on the four steps of the plan, do, study, and act. The cycle enables the Clinical Nurse Leader (CNL) to lead improvement on the original change idea and thereby increase the likelihood of success of the project (Nelson, Batalden, & Godfrey, 2007). The “do” part of the author’s PDSA included collaborating with surgeons and the orthopedic team to gather instructions on postoperative medication, wound care, and limitations. The surgeon and orthopedic team were eager to assist in the QI project, therefore, limiting barriers to complete this step of the cycle. An interdisciplinary team was quickly formed between the author, surgeon, physician assistants, assistant nurse manager, a CNL, and nurses within the microsystem. Establishing an interdisciplinary team assists in eliminating a silo mindset and creates a unified vision. The author initially aimed to compile an after-visit summary document that is surgeon specific to have available on the unit for nursing staff to distribute to patients. After working closely with the interdisciplinary team, it was decided that the team of orthopedic physician assistants would be responsible for entering the discharge instructions into the patient’s after visit summary once notified by the primary nurse that the patient is medically stable to be discharged home. This strengthens the communication and teamwork on the day of surgery. Nurses in the microsystem were educated on standardized education in order to promote competency at the time of the discharge process. Nursing staff completed a post-survey consisting of four questions to evaluate their knowledge of the discharge process for ambulatory total joint patients as well as if they had been provided with the necessary education tools. Post survey results indicated that nurses strongly agreed that they were provided with the necessary educational tools to competently discharge and care for the ambulatory total joint patient. Results from the post-survey indicated that nurses in the clinical microsystem were competent in the ambulatory total joint patient pathway as well as having the necessary resources and support from the orthopedic team to complete the discharge process. 84% of nurses who completed the post-survey agreed they know who to contact when the ambulatory total joint patient is ready and 89% agreed that they were provided with a variety of education regarding patients having ambulatory total joint surgery.
Sub-Categorization: Total Joint - Hip/Knee innovations
Session Type: Podium

Learner Outcome: Implement processes to standardize patient education provided to Total Joint Arthroplasty patients in the ambulatory setting.

Category: A
Sub-Categorization: Total Joint - Hip/Knee innovations
Session Type: Podium

Learner Outcome: Implement processes to standardize patient education provided to Total Joint Arthroplasty patients in the ambulatory setting.

Category: A

Speakers

Lead Presenter
Jamie Lantz, MSN, RN, CNL
Hospital for Special Surgery
Presenter 2
Shawna Townsend, MSN, RN, CPN, CNL, ONC
Hospital for Special Surgery

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