The average length of stay for patients undergoing total joint replacement surgery at a large teaching hospital is 3 days. This requires a comprehensive discharge education plan. The purpose of this prospective quality improvement project was to evaluate patients' understanding of postoperative care at home, screen for postoperative complications, and identify inconsistencies or gaps in discharge teaching. During a 1-year evaluation period, patients who underwent total joint replacement surgery were interviewed via a telephone call following discharge to home. Patients were asked questions regarding general feeling, pain, wound appearance, edema, anticoagulation, and physical therapy. Concerns reported most frequently included medication side effects, deep vein thrombosis prophylaxis, and the use of assistive devices. The majority of patients reported receiving adequate discharge instructions. This quality improvement project has resulted in improved discharge teaching based on patients' identified needs and early intervention for the prevention of postoperative complications.
Ann Marie Darcy, BSN, RN, Clinical Educator, Beth Israel Deaconess Medical Center, Boston, MA.
Gina A. Murphy, BSN, RN, Nurse Manager, Beth Israel Deaconess Medical Center, Boston, MA.
Susan DeSanto-Madeya, PhD, RN, Nurse Scientist, Beth Israel Deaconess Medical Center, Boston, MA, and Associate Professor, William F. Connell School of Nursing, Boston College, Chestnut Hill, MA.
The authors have disclosed that they have no financial interests to any commercial company related to this educational activity.