Abstract

Total knee arthroplasty (TKA) is the most commonly performed inpatient surgical procedure within the USA and is estimated to reach 3.48 million procedures annually by 2030. An aging population with multiple health conditions coupled with value-based care initiatives focusing on the trend toward outpatient care and patient satisfaction, has prompted healthcare providers to develop and implement an anesthetic approach to enhance TKA outcomes. The American Association of Hip and Knee Surgeons acknowledges the movement toward outpatient TKAs emphasizing minimal complications and maximizing patient safety. A review of current literature identifies causative factors delaying hospital discharge following TKA ranging from postoperative pain to delayed postoperative mobility. Despite the need for outpatient care, there are no anesthetic guidelines for improved TKA outcomes; specifically, the timeframe associated with the onset of anesthesia to patient mobility. The purpose of this study was to identify correlational relationships between the type of neuraxial anesthetic approach, dosage of neuraxial anesthetic administered, and the patient's readiness for postoperative ambulation as determined by the neuro-motor assessments by the staff nurses. Keywords: total knee replacement, neuraxial anesthesia, postoperative mobility, outpatient, medication dose.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 28031167; ProQuest document ID: 2437393280. The author still retains copyright.

Author Details

James Thomas Papesca, DNP, MSN, CRNA, APRN

Sigma Membership

Pi Epsilon at-Large

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Cohort

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Medication Dose, Neuraxial Anesthesia, Postoperative Mobility, Total Knee Replacement

Advisor

Nora Hamilton

Second Advisor

Robert Martin Reynolds

Third Advisor

Judith Lindsay

Degree

DNP

Degree Grantor

Regis College

Degree Year

2020

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2021-08-20

Full Text of Presentation

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