Advertisement for orthosearch.org.uk
Orthopaedic Proceedings Logo

Receive monthly Table of Contents alerts from Orthopaedic Proceedings

Comprehensive article alerts can be set up and managed through your account settings

View my account settings

Visit Orthopaedic Proceedings at:

Loading...

Loading...

Full Access

General Orthopaedics

ENHANCED RECOVERY IN TOTAL HIP AND KNEE REPLACEMENT

The South West Orthopaedic Club (SWOC)



Abstract

The Enhanced Recovery Pathway aims to improve the patient experience as well as expediting discharge. We aim to discharge 85% of patients by day 3. This audit retrospectively looked at primary total hip replacements (THR) and total knee replacements (TKR) patients who had 7 days length of stay and evaluated the factors contributing to the delay.

There were 24 patients who stayed 7 days, 12 THR and 12 TKR. There were 15 females and 7 males, the mean age was 77 years (52 to 89). Causes for the delay included patient's reluctance to engage in their rehabilitation (21/24) and Occupational Therapists (OT) identifying difficulties in patient's home circumstances on admission (12/24). Medical problems also delayed early mobilisation, particularly urethral catheterisation (9/24), investigation for venous thromboembolism (6/24) and blood transfusion (3/24).

Delay in discharge is multifactorial and requires involvement of MDT. We have identified ways to enhance patient engagement, including a “patient journey” DVD shown preoperatively at “Joint School” and individual white boards for daily goal setting. Fostering greater self-efficacy in patients may improve participation in preoperative discharge planning with OTs. Specific preoperative education may help patients understand the importance of continuing their rehabilitation while medical problems are managed.