Implementing evidence-based pre-operative education in hospitalized patients undergoing total knee replacement: a best practice implementation project

Abstract

ABSTRACT Introduction: Pre-operative education is a key factor influencing post-operative recovery, patient expectations of surgery, and patient satisfaction. Although there are guidelines for the pre-operative education of patients undergoing knee replacement, pre-operative education of patients remains suboptimal. Objectives: This study aimed to improve the knowledge and skills of health care providers and patients undergoing elective knee replacement. The project used pre-operative education to increase compliance with best practices. Methods: This project was conducted from January to October 2022 in the orthopedic department of a tertiary hospital in China. The project was conceptually guided by the JBI Model of Evidence-Based Healthcare, while the JBI Evidence Implementation Framework was used to guide the implementation. Two audit criteria were developed for the baseline and follow-up audits, which assessed 20 patients undergoing elective knee replacement. Results: A comparison of the audit outcomes revealed that for Criterion 1, the percentage of patients receiving pre-operative education in both audits was 100%. For Criterion 2, the compliance rate increased significantly from 0% in the baseline audit to 90% in the follow-up audit. Conclusions: A clinical audit is an effective approach to improving compliance with recommended best practices. Leadership, team resource management, education, and monitoring were helpful in implementing the best practices. Further audits will need to be conducted to maintain practice changes and ensure that the project is sustainable.