Development of a Nurse Practitioner‒Managed Preoperative Evaluation Clinic Within a Multispecialty Orthopedic Practice

Sebach, Aaron M.; Rockelli, Laurie A.; Reddish, Walton; Jarosinski, Judith M.; Dolan, Charles L

doi:10.1016/j.nurpra.2015.06.006

Cited by 15 publications

(40 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have reported a significant decrease in total DOS cancellation rates after implementing preoperative interventions or remodelling preoperative care processes. However, the results are not easily comparable to ours, as the definitions for DOS cancellations vary between studies (Boudreau & Gibson, ; Deng et al., ; Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ) and for example the three category classification (patient, physician, hospital) presented by Tung, Dexter, Jakubczyk, and Glick () would have given too limited information for our study purposes (Dexter et al., ; Tung et al., ). Other studies are also based on limited patient groups (Boudreau & Gibson, ; Deng et al., ; Higson & Finlay, ) or were conducted in substantially smaller hospitals than in this study (Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ; Siragusa et al., ).…”

Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

“…Implementation of preoperative units or the development of structured and patient‐centred preoperative care models has been demonstrated to be an effective strategy in shortening the length of stay, improving bed management (Ortiga et al., ) and reducing DOS cancellations in general (Bathala, Tardolli, Jaramillo, Morgan, & Thomas, ; Gheysari, Yousefi, Soleymani, & Mojdeh, ; Hovlid, Bukve, Haug, Aslaksen, & von Plessen, ; McKendrick, Cumming, & Lee, ; Sebach et al., ; Siragusa, Thiessen, Grabowski, & Young, ) and in children's hospitals (Higson & Finlay, ). Patients appreciate new individualised interventions, as they feel involved in preoperative planning and scheduling as patient autonomy increases (Hovlid, von Plessen, Haug, Aslaksen, & Bukve, ).…”

Section: Introductionmentioning

confidence: 99%

“…It has been stated that the success of a preoperative process can be well monitored by last‐minute cancellations (Verma et al., ). Several comparative studies presented positive outcomes of interventions carried out in the preoperative process to reduce cancellations (Bathala et al., ; Boudreau & Gibson, ; Deng et al., ; Gheysari et al., ; Haufler & Harrington, ; Hovlid et al., ; McKendrick et al., ; Ming Teh et al., ; Muckler et al., ; Sebach et al., ; Siragusa et al., ) (Table ). To the best of our knowledge, this is the first study to evaluate the impact of implementing an evidence‐based and structured preoperative protocol in a university hospital with all operative specialties included while also searching for meaningful factors in organising preoperative care to reduce day of cancellations.…”

Section: Introductionmentioning

confidence: 99%

“…A <2% DOS cancellation rate can be achieved in tertiary care for all procedures if the processes are well designed and supervised by the department of anaesthesiology and if a significant part of the preoperative patient assessments is dedicated to selective nursing processes (Olson & Dhakal, 2015). Preoperative nurse practitioners are acknowledged as highly qualified, independent healthcare providers, and the implementation of nurse practitioner-managed preoperative evaluation clinics is strongly recommended (Sebach, Rockelli, Reddish, Jarosinski, & Dolan, 2015). Implementation of preoperative units or the development of structured and patient-centred preoperative care models has been demonstrated to be an effective strategy in shortening the length of stay, improving bed management (Ortiga et al, 2010) and reducing DOS cancellations in general (Bathala, Tardolli, Jaramillo, Morgan, & Thomas, 2013;Gheysari, Yousefi, Soleymani, & Mojdeh, 2016;Hovlid, Bukve, Haug, Aslaksen, & von Plessen, 2012;McKendrick, Cumming, & Lee, 2014;Sebach et al, 2015;Siragusa, Thiessen, Grabowski, & Young, 2011) and in children's hospitals (Higson & Finlay, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The impact of a structured preoperative protocol on day of surgery cancellations

Turunen

Miettinen

Setälä

et al. 2017

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives:To evaluate the impact of implementing an evidence-based, structured preoperative protocol on day of surgery cancellations in 13 operative specialties.Background: Surgery cancellations cause unnecessary harm for patients and organisations as many cancellations could be prevented. Preoperative care has developed in recent years, and several preoperative interventions have been introduced. However, the optimal model for organising preoperative care remains unknown. Cancellations are a commonly used indicator when evaluating the success of preoperative care.Design: Observational study with two study phases: before and after.Methods: The cancellation data were collected from the hospital register from 1September 2013-31 May 2014 (n = 591) and from September 2015-May 2016(n = 542). The compliance rate of the preoperative protocol was evaluated in group sessions (n = 13) during spring 2016 using the participation of preoperative healthcare professionals (n = 49). The data were analysed statistically.Results: Cancellation rates varied between 1.6%-9.7% (in the first phase) and between 1.5%-7.7% (in the second phase). A remarkable decrease was found in patients who failed to attend their scheduled procedures. The mean of compliance to the preoperative protocol across all specialties was 82.3%. A correlation between the rate of cancellation and the rate of compliance with the preoperative protocol was found.Conclusions: A preoperative protocol promotes the scheduled arrival of surgical patients to the hospital and therefore decreases cancellation rates.Relevance to clinical practice: An evidence-based preoperative care protocol should be introduced for all healthcare professionals working in preoperative care to ensure smooth, safe and high-quality care for surgical patients. | INTRODUCTIONCancellations are a problem in perioperative care, and most of them are preventable (Kumar & Gandhi, 2012). It has been estimated that 50%-65% of cancellations could be potentially avoided (Chughtai, Michael, & Qurashi, 2014;Fitzsimons, Dilley, Moser, & Walker, 2016;Kim & Lee, 2014). In this study, day of surgery cancellation (DOS) is defined as a scheduled elective operative procedure that was cancelled on the same day it was planned to occur. DOS cancellations are described to be one of the 23 nursing-sensitive quality indicators for evaluating and monitoring efficiency, patient safety and crisis event management in perioperative care (Wu et al., 2017 The largest costs of cancelled surgeries after the preparation of the surgery room and during the surgery itself are related to human resources (62.8%) (Perroca, Jerico Mde, & Facundin, 2007).In tertiary care paediatric outpatient surgical centres, the cost of a cancelled urology patient was 4,802 US dollars, which led to an approximately 500,000 dollar loss over a 7-month period with a cancellation rate of 13.3% (Pohlman, Staulcup, Masterson, & Vemulakonda, 2012). Calculating the actual overall cost of cancellations is complicated because of the variations in care ...

show abstract

Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The impact of a structured preoperative protocol on day of surgery cancellations

Turunen

Miettinen

Setälä

et al. 2017

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based on Patient Demographics

Petrone¹,

Fakhoury²,

Matai³

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

Purpose: To evaluate whether patient demographics are associated with cancellation of elective orthopaedic sports medicine surgical procedures. Methods: We retrospectively reviewed the electronic medical records of 761 patients who were scheduled to undergo an elective sports medicine orthopaedic operation from January 1, 2015, to December 31, 2017. The patients were divided into 2 groups: those who underwent the scheduled procedure (group A) and those in whom the operation was canceled for any reason prior to the surgical date and not rescheduled (group B). Univariate analysis assessed patient factors consisting of age, sex, race, language, marital status, occupation status, type of insurance (Medicaid or Medicare vs private), smoking history, employment status, and history of surgery to determine which demographic factors led to an increased risk of elective case cancellation. Results: Patients who canceled were significantly older (46.5 years vs 41.5 years, t ¼ 2.432, P ¼ .015) than those who do not. In addition, current smokers (22.5% vs 10.9%, c 2 ¼ 10.85, P ¼ .001), patients with Medicare or Medicaid versus private insurance (16.7% vs 10.0%, c 2 ¼ 5.35, P ¼ .021), noneEnglish-speaking patients (29.5% vs 11.6%, c 2 ¼ 11.43, P ¼ .001), and patients without a history of surgery requiring anesthesia (18.8% vs 9.6%, c 2 ¼ 9.96, P ¼ .002) were all more likely to cancel. When all studied variables were examined in a logistic regression analysis, of the above demographic variables, only insurance status was no longer significant, given its correlation with age and language. Conclusions: Increased age (46.5 years), non-English speaking, smoking, lack of a history of surgery requiring anesthesia, and Medicaid or Medicare insurance were found to contribute to an increased risk of elective orthopaedic surgery cancellation. Level of Evidence: Level III, case-control study.

show abstract

The orthopaedic nurse practitioner: Breaking tradition to fill gaps in care delivery through varied scopes of practice

O'Rourke

2022

International Journal of Orthopaedic and Trauma Nursing

View full text Add to dashboard Cite

Development of a Nurse Practitioner‒Managed Preoperative Evaluation Clinic Within a Multispecialty Orthopedic Practice

Cited by 15 publications

References 8 publications

The impact of a structured preoperative protocol on day of surgery cancellations

The impact of a structured preoperative protocol on day of surgery cancellations

Predicting Elective Orthopaedic Sports Medicine Surgical Cancellations Based on Patient Demographics

The orthopaedic nurse practitioner: Breaking tradition to fill gaps in care delivery through varied scopes of practice

Contact Info

Product

Resources

About