The Association between Preoperative Instruction on Length of Hospital Stay in Total Knee Replacements

Preoperative instruction has been a critical aspect of surgical procedure since the 1970s when hospitals started formal programs. With the recent push for health care reform, all aspects of the medical profession are looking toward cost reduction. This independent study proposal was designed to assess the comparison of length of hospitalization in total knee replacement patients who have preoperative instruction versus those who do not receive preoperative instruction. Problem with the prior research involving preoperative teaching included the following: a wide variety of surgical diagnoses, the number of different physicians performing the surgeries, the small sample sizes, and outdated literature. The proposal employs a chart review of an experimental group-control group design. The experimental group teaching program includes viewing a 10-minute video concerning total knee replacement; question/answer session with nursing staff; and review of total knee replacement exercises, transfers, and ambulation with a physical therapist. Patient charts were randomly chosen from the time period January 1, 1990 through December 31, 1991. Each chart met the criteria for selection. Twenty charts were analyzed from each group to determine the average length of hospitalization. An analysis of variance of means was completed, with appropriate Hest application at the 0.05 level of significance. The implications of this study indicate that additional steps must be taken to continue quality of patient care while reducing overall medical costs. The advent of the preoperative instruction is one quarter of a century old and requires updated data for justification of its use