A practical guide to improving patient outcomes

With advancements in research and technology, total joint arthroplasty has become one of the most consistently successful procedures in use today. Relief of pain and improvement in movement and joint function are among the most important benefits of total joint arthroplasty. However, patient involvement and contribution to the recovery process frequently make the difference in achieving optimal outcomes. Therefore, efforts to improve patient outcomes need to be patient-focused and address patient participation, beginning in the outpatient setting through hospitalization and discharge. Early preparation of the patient (physically, emotionally, and psychosocially) for surgery and rehabilitation is essential to improving patient outcomes. Patients who understand and are knowledgeable about the entire total joint arthroplasty process have faster recoveries and fewer problems. With preadmission patient education, patients experience less anxiety and emotional distress and have increased coping skills because they know what to expect. Through effective interviewing and assessment, the nurse can identify and address individual patient needs. As understanding and confidence increases, the patient's feeling of control increases. This encourages the patient to become involved and to actively participate in the therapeutic process. The orthopaedic nurse serves as the primary conduit for knowledge and understanding as the patient prepares for and progresses through the perioperative period. Working with the health care team to develop, support, and implement the interdisciplinary plan of care, the orthopaedic nurse ensures quality of care and improved outcomes during preadmission, hospitalization, and discharge/follow-up.