Article type
Abstract
Background: Preoperative education (PE) of individuals undergoing total knee arthroplasty has been proven to positively influence variables such as shortened hospital stays, improved fulfillment of expectations, and reduced occurrence of postoperative complications. Recognizing its pivotal role in optimizing patient experiences and outcomes, the implementation and improvement of preoperative education in clinical settings should be a subject of keen interest.
Objectives: The aim of the implementation project was to improve and harmonize the practice of total knee arthroplasty PE.
Methods: The implementation project was carried out in a German hospital's orthopedics and traumatology department, a certified joint replacement center. JBI Evidence Implementation framework was used. The baseline and follow-up audits (interviews) were conducted on ten patients, three surgeons, two nurses, and two physiotherapists. The content and frequency of preoperative education were changed according to the baseline audit results. The change was facilitated using individual talks and discussions on the institutional guidelines, booklet revision, and workshops.
Results: The baseline audit revealed that PE was already developed in the setting, but patients’ expectations had been rarely addressed. Additionally, the physiotherapists were not involved in this process because the first physiotherapeutic consultation was scheduled on a regular basis after surgery. Therefore, during the implementation phase, they were asked to refer to its content in postoperative inpatient care. Also, surgeons were encouraged to incorporate patients’ expectations in the PE. The follow-up audit determined improved PE regarding patients' expectations and recovery. One finding of the re-audit was that patients partially do not remember what they were educated on.
Conclusions: The PE of total knee arthroplasty patients in the setting was already well established. The main barriers to harmonizing the process lie within accessibility and stakeholder involvement before surgery, but not in disagreements between stakeholders. Effective communication strategies are needed when delivering PE content and among the stakeholders to provide patients with lasting knowledge.
Objectives: The aim of the implementation project was to improve and harmonize the practice of total knee arthroplasty PE.
Methods: The implementation project was carried out in a German hospital's orthopedics and traumatology department, a certified joint replacement center. JBI Evidence Implementation framework was used. The baseline and follow-up audits (interviews) were conducted on ten patients, three surgeons, two nurses, and two physiotherapists. The content and frequency of preoperative education were changed according to the baseline audit results. The change was facilitated using individual talks and discussions on the institutional guidelines, booklet revision, and workshops.
Results: The baseline audit revealed that PE was already developed in the setting, but patients’ expectations had been rarely addressed. Additionally, the physiotherapists were not involved in this process because the first physiotherapeutic consultation was scheduled on a regular basis after surgery. Therefore, during the implementation phase, they were asked to refer to its content in postoperative inpatient care. Also, surgeons were encouraged to incorporate patients’ expectations in the PE. The follow-up audit determined improved PE regarding patients' expectations and recovery. One finding of the re-audit was that patients partially do not remember what they were educated on.
Conclusions: The PE of total knee arthroplasty patients in the setting was already well established. The main barriers to harmonizing the process lie within accessibility and stakeholder involvement before surgery, but not in disagreements between stakeholders. Effective communication strategies are needed when delivering PE content and among the stakeholders to provide patients with lasting knowledge.