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Paul M. Levy – The Total Joint Replacement Patient Supporting a Successful Journey
Description:
When is it time for surgery?
The latest in operative procedures:
Total Joint Arthroplasty
Bipolar Hip Arthroplasty
Open Reduction Internal Fixation
Megaprothstetics
Key strategies to prevent post-operative complications/risks
Achieving success: Rehabilitation goals and discharge planning
Joint Commission S.C.I.P. (Surgical Care Improvement Project) Protocols
Pain management techniques to meet realistic patient goals
Joint replacement surgeries have become common place – over a million performed per year. Paul M. Levy, MSN, BS, RN, ONC is excited to share his expertise in orthopedics to provide a better understanding of Total Joint Replacement Surgery:
Pre-operative diagnosis: When is it time for surgery? Alternative treatments?
Multiple joint replacements & the implications of each
The key to preventing post-operative complications/risks
All the options: Megaprosthetic replacements, fixations, joint revisions…
Achieving success: Rehabilitation goals and discharge planning
Recent changes to CMS reimbursement (Value Based Purchasing or VBP) processes have put a premium on ensuring patient satisfaction is achieved. Failure to meet baseline measurements in HCAHPS scores will result in decreased reimbursements for hospitals. In addition, 30-day readmission rates also will affect VBP scores. This recording will provide strategies to address the following areas that can impact VBP:
Co-morbidity – discussion of medical management of preexisting conditions
Pain Management – setting and meeting realistic pain management goals
Communication – focus on patient education and follow-up care
Readmission – focus on tools to reduce infection and post-operative complications
This recording will leave with you a clear understanding of the entire process from start to finish for total joint patients. This will in turn allow interdisciplinary healthcare professionals to help their patients better understand the process, have realistic expectations, and improved satisfaction following surgical interventions.
Objectives
Evaluate the key indications for timing of joint replacement surgery.
Compare treatment options for patients with severe joint pain.
Analyze options for pre-operative education to make multiple learning modalities available to patients.
Examine the necessary rationale for pre-operative testing.
Summarize the Joint Commission SCIP Protocols as related to Total Hip Arthroplasty, Total Knee
Arthroplasty, Hip and Knee Revisions, and Hip Fracture repairs (ORIF).
Assess a multi-modal approach to post-operative pain.
Determine preventive measures for the most significant post-surgical complications that can occur.
Distinguish between the most effective planning strategies for patient success following hospital discharge.
Outline
Pre-operative Work-up
The pre-operative work-up is a vitally important part of the operative process. Not all patients with arthritis require surgery. Knowing the treatment options allows patients to make informed decisions about their care. Radiology examples will be included for case study discussion.
Diagnosis
Osteoarthritis
Bone Cancers
Recurrent Infections
Acute Injury, Falls, i.e.
Treatment Options
Exercise / Physical Therapy
Injections
Operative Treatments
Pre-operative Planning
Understanding the processes that need to take place prior to the surgery will help the patient better prepare for the surgery, allow for less patient anxiety and establish realistic goals and expectations.
Pre-operative Testing
Pre-operative Clearances
Medical
Cardiac
Pulmonary
Other/Individualized
Obtaining Consent
Pre-operative Education
One-to-one education
Online education
Pre-operative joint classes
Surgical Procedures
Fixation
Treatment for fractures that do not require joint replacement
Total Joint Replacement
Hip
Knee
Shoulder
Other Joints
The elbow, wrist, and ankle can also be replaced, but these surgeries are performed far less frequently. As well, there is currently a disk replacement surgery in study, but it is not yet FDA approved.
Megaprosthetic Replacements
Replacement of both the joint and a portion of the surrounding bone
Joint Revisions
Immediate Post-Operative Care
Multi-modal Pain Management
Oral vs. IV
Nerve blocks
Ambulation
IV acetaminophen / NSAIDs
Intra-operative steroid injection
Age-related analgesia
Opioid tolerance
Physical and Occupational Therapy
Positioning
Movement restrictions
Exercises
Assistive devices
Wound Care / Infection Prevention
Dressings
Antibiotics
VTE Prophylaxis
Mechanical
Pharmaceutical
Joint Commission S.C.I.P. (Surgical Care Improvement Project) Protocols
Surgical/Medical Complications
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Post-acute Care and Follow-up
Discharge Planning
Acute Rehab / Skilled Nursing / Home
Follow-up appointments
Home medications
Readmission/complications
