Pre-Operative Education for Total Knee Replacement: A Pilot Survey

Purpose: The structure of preoperative education programs used nationally for patients prior to total knee replacement (TKR) surgery has not been identified previously, thus hospitals across the United States lack a common standard for this preoperative education to ensure best patient outcomes. The purpose of this pilot survey study was to describe the content, providers, and delivery methods currently utilized to deliver preoperative education for total knee replacement in the United States. Method: Data were collected using an online survey developed by the authors based on review of literature and 3 preoperative programs and was distributed through the Research Electronic Data Capture (REDCap). The survey consisted of 16 questions, including 12 closed-ended and 4 open-ended items. Participants were identified through convenience sampling using contacts of the first author and an Internet search of hospitals that provided preoperative education. Seven professional participants from nursing, physical therapy, and occupational therapy completed the survey. Descriptive statistics were used for data analysis of the 12 quantitative questions to determine frequency and percentages of responses. Responses on the 4 open- ended survey items as well as participant responses of “other” for question items were recorded and collated from individual survey responses. Results: Preoperative education provider teams for total knee replacements most frequently consisted of nursing, physical therapy, and occupational therapy staff. Most education programs were provided 2 weeks prior to surgery in a group format with the majority of programs being delivered in a single session, lasting between 1 and 1.5 hours. Verbal and written instruction were the most commonly utilized methods to deliver education. Individual patient programs included a variety of topics, ranging from the expectations while in the hospital, self-care, adaptive equipment, and home safety, being some of the most commonly included content. Conclusions: With this pilot study, we have provided a framework to describe the structure of preoperative total knee replacement education nationally, which can be used to guide a future large-scale survey to fully describe the content, providers, and delivery methods of preoperative education for this population across the United States, using a representative sample