Keeping Up With Current Orthopaedic Nursing Practice: Results of the ONCB 2016 Role Delineation Study BACKGROUND: The Orthopaedic Nurses Certification Board (ONCB) conducts a role delineation study (RDS), also known as a job task analysis, every 5 years. Results identify tasks performed by orthopaedic registered nurses and nurse practitioners, as well as musculoskeletal health conditions commonly experienced by their patients. PURPOSE: The purpose of this study was to define current practice patterns among orthopaedic nurses and nurse practitioners to determine content for future certification examinations. METHOD: An online survey methodology was used to identify task and knowledge statements representative of orthopaedic nursing practice. FINDINGS: Of 6,462 e-mails sent, 904 valid responses were returned (response rate 13.9%). This is lower than results of the Orthopaedic Nurses Certification Board's 2010 RDS (22.7% response rate) but is considered acceptable for an RDS. CONCLUSION: Survey results were analyzed by ONCB Test Committee members with guidance from psychometric staff at PSI/AMP. PSI/AMP staff were used to review and revise examination specifications for the Orthopaedic Nurse Certified (ONC) and Orthopaedic Nurse Practitioner-Certified (ONP-C) certification programs. New examination specification and passing points were implemented with April 2018 testing.

Keeping Up With Current Orthopaedic Nursing Practice: Results of the ONCB 2016 Role Delineation Study No abstract available

Primary Prevention to Maintain Cognition and Prevent Acute Delirium Following Orthopaedic Surgery Cognitive impairment is a recognized predictor of acute delirium, particularly in the postoperative period. Estimates of up to 24% of patients experiencing delirium and its associated cognitive impairment during any orthopaedic procedure have been reported, with higher rates for those patients undergoing hip fracture repair. Primary prevention is the most effective strategy to maintain cognition and prevent delirium. The purpose of this article is to provide evidence-based recommendations to prevent acute delirium using bundles of care. Bundles of care are a set of 3–5 independent, evidence-based interventions that, when implemented together, result in significantly better outcomes than when implemented individually. The bundle consists of ongoing assessment of cognition, continuing orientation, and early mobilization and socialization.

Primary Prevention to Maintain Cognition and Prevent Acute Delirium Following Orthopaedic Surgery No abstract available

Spinal Stenosis Patients' Visual and Verbal Description of the Comprehension of Their Surgery BACKGROUND: Spine surgery patients have difficulty comprehending the patient education aimed at preparing for surgery. PURPOSE: To assess the effect of a specific preoperative education approach (Knowledge Test Feedback Intervention, KTFI) on patients' verbal and visual understanding of their surgery. METHODS: In this randomized controlled trial, the intervention group (n = 50) went through the KTFI and routine education, whereas the control group (n = 50) received only routine patient education. Written description of the surgical procedure and drawing of incision were used as outcome measures at baseline, at hospitalization, at discharge, and 3 and 6 months after surgery. RESULTS: At baseline, half of the participants showed verbal and visual understanding of their surgery. During follow-up, understanding improved significantly with no statistically significant differences between the groups. CONCLUSION: Spinal stenosis patients' understanding of their surgical procedure is imperfect. Patient educators need to ensure patient learning by evaluating comprehension outcomes.

Impact of Bundled Care on Outcomes Following Elective Primary Total Hip or Total Knee Arthroplasty BACKGROUND: Standardized approaches to care and care pathways for patients with joint replacement have been shown to decrease length of stay (LOS), improve patient participation in education, decrease patient anxiety while improving perception of care, and lead to overall efficiency and improved care and outcomes. PURPOSE: The purpose of this study was to determine whether implementation of a standardized bundle approach to care influenced the outcomes after total hip or total knee arthroplasty (THA or TKA). METHODS: A retrospective, quasi-experimental before- and after-design study was used to evaluate the impact of the intervention. Two hospitals implemented a standardized bundle of care for patients undergoing THA or TKA that included preoperative patient education, day of surgery mobilization, and a total joint group physical therapy session (Full Bundle). Data analyses were completed on a convenience sample of 2,200 patients who underwent THA or TKA. Outcomes data measured were LOS, discharge disposition, costs, and readmission rate. RESULTS: Patients receiving the Full Bundle had significant reduction in LOS of roughly 1 day (OR = 1.687, 95% CI [1.578, 1.797]) versus group not receiving all elements (OR = 2.706; 95% CI [2.623, 2.789]). Full Bundle patients were 6 times more likely to be discharged home compared with the Partial Bundle group (OR = 6.01, 95% CI [4.01, 9.03]). Full Bundle group had significantly lower total direct costs, F(1) = 4.06, p = .046, partial η2 = 0.003. There were no differences in readmission rates between the 2 groups. CONCLUSION: Patients who had all elements of the THA/TKA bundle had the best outcomes. By improving efficiencies of care through the use of the bundle, the 2 hospitals positively impacted the care and outcomes of THA and TKA patients.

Combined Intermittent Pneumatic Leg Compression and Pharmacological Prophylaxis for Prevention of Venous Thromboembolism No abstract available