Date of Award
Doctor of Nursing Practice Final Manuscript
Doctor of Nursing Practice
Dr. Joseph Burkard, DNSc, CRNA, Faculty Chairperson
Dr. Scott Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, Seminar Faculty
The purpose of this evidence-based project was to reduce the rate of elective total joint arthroplasty case cancellations by implementing a nurse practitioner-led Preoperative Assessment Clinic (POAC), in the orthopedic department of a major southern California Veterans Affairs (VA) hospital. Retrospective data collected in a 12-month time period showed a surgical cancellation rate of 22%. Reasons for delays or cancellations included: medical instability, abnormal labs and/or studies, patients requiring referral to specialists, dental clearance, patient-initiated cancellations, and active infections. The POAC reduced the rate of case cancellations at 1 year to 17% and at 2 years to 9%. Lost revenue for 12 case cancellations 2 years post-implementation was $62,940, whereas lost from 31 case cancellations prior to implementation was $162,595. A chi-squared test was performed to determine the relationship between the POAC and case cancellation rates. The relationship between these variables was statistically significant (chi-squared= 8.541, p = .003).
The results demonstrate that a nurse practitioner-led POAC reduces surgical case cancellation rates, improving patient outcome, reducing wasted resources, and increasing patient satisfaction.
Digital USD Citation
Adriano, Angelica, "Preoperative Assessment Clinic Reduces Total Joint Arthroplasty Case Cancellations" (2016). Doctor of Nursing Practice Final Manuscripts. 9.