Project Title

A Mixed-Methods Study of the Content, Providers, and Delivery Methods of Preoperative Education for Persons Undergoing Total Knee Replacement

Department

Occupational Science and Occupational Therapy

Abstract

Most patients have positive results following total knee replacement (TKR) surgery, however others experience negative outcomes such as falls, reduced function, and hospital readmission. Readiness for discharge after TKR begins with preoperative education to prepare patients for surgery and the postoperative phase. It is essential to describe the current structure of preoperative education nationally as a mechanism for better preparing patients to return home following TKR.

This research study used mixed-methods to explore the current structure of preoperative education for TKR in the United States. Orthopedic nurses completed an online survey to describe their preoperative education program. The majority of participants provided preoperative education as part of interprofessional teams in either a group format or a format that included both group and individual components. Verbal instruction was the most common educational delivery method followed by written instruction. Most preoperative education classes lasted between 1 and 2 hours, were delivered in a single session, and included a variety of topics. Orthopedic nurses were then interviewed followed by qualitative analysis of transcripts for common themes among participants. Participants expressed that preoperative education was a significant component impacting patient outcomes following surgery. Interprofessional preoperative education was valued by participants, but pragmatic factors were identified as barriers to the inclusion of other disciplines within these programs. Education programs were constantly evolving based on current evidence-based practice and changes to orthopedic protocols. Descriptions of preoperative programs nationally combined with providers’ perceptions provide a strong basis for determining best practice to support better postoperative patient outcomes.

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A Mixed-Methods Study of the Content, Providers, and Delivery Methods of Preoperative Education for Persons Undergoing Total Knee Replacement

Most patients have positive results following total knee replacement (TKR) surgery, however others experience negative outcomes such as falls, reduced function, and hospital readmission. Readiness for discharge after TKR begins with preoperative education to prepare patients for surgery and the postoperative phase. It is essential to describe the current structure of preoperative education nationally as a mechanism for better preparing patients to return home following TKR.

This research study used mixed-methods to explore the current structure of preoperative education for TKR in the United States. Orthopedic nurses completed an online survey to describe their preoperative education program. The majority of participants provided preoperative education as part of interprofessional teams in either a group format or a format that included both group and individual components. Verbal instruction was the most common educational delivery method followed by written instruction. Most preoperative education classes lasted between 1 and 2 hours, were delivered in a single session, and included a variety of topics. Orthopedic nurses were then interviewed followed by qualitative analysis of transcripts for common themes among participants. Participants expressed that preoperative education was a significant component impacting patient outcomes following surgery. Interprofessional preoperative education was valued by participants, but pragmatic factors were identified as barriers to the inclusion of other disciplines within these programs. Education programs were constantly evolving based on current evidence-based practice and changes to orthopedic protocols. Descriptions of preoperative programs nationally combined with providers’ perceptions provide a strong basis for determining best practice to support better postoperative patient outcomes.