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Nursing Strategies to Reduce Length of Stay for Persons Undergoing Total Knee Replacement: Integrative Review of Key Variables

Hass, Shelly MSN, CNL; Jaekel, Camilla PhD, RN; Nesbitt, Bonnie PhD, ANP-BC

doi: 10.1097/NCQ.0000000000000104

Decreasing the length of stay for persons undergoing total knee replacement surgery can improve patient and organizational outcomes while reducing health care costs. This integrative review examined selected nurse-driven variables that assist the interdisciplinary team to reduce length of stay. Findings suggest that a targeted clinical pathway including comprehensive preoperative patient education, physical therapy on the day of surgery, multimodal pain control, and proactive discharge planning may provide the best practice with this patient population.

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Mayo Clinic Health System—Franciscan Healthcare, La Crosse, Wisconsin (Ms Hass and Dr Jaekel); and Viterbo University, La Crosse, Wisconsin (Dr Nesbitt).

Correspondence: Camilla Jaekel, PhD, RN, Mayo Clinic Health System—Franciscan Healthcare, 700 West Ave South, La Crosse, WI 54601 (

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The authors declare no conflict of interest.

Accepted for publication: September 27, 2014

Published ahead of print: December 5, 2014

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