Date of Award

Spring 5-17-2021

Document Type

DNP Project

Project Team Faculty Member

Rebecca Collier

Project Team Faculty Member

Joe Grazaitis


enhanced recovery after surgery (ERAS), orthopedic, lower extremity arthroplasty, opioid-sparing, TKA, THA


The demand for total knee arthroplasty (TKA) and total hip arthroplasty (THA) will continue to rise as life expectancy increases. Coupling increased age with the increased prevalence of both obesity and osteoarthritis, the need for total joint arthroplasties is likely to increase (Oseka & Pecka, 2018). The frequency of arthroplasty procedures and the associated recovery period lead to heavy economic demands felt by most healthcare systems (Stowers et al., 2016). To address this burden, enhanced recovery after surgery (ERAS) protocols have been implemented at institutions and are designed to improve patient outcomes while simultaneously limiting cost and reducing readmission rates after surgery (Kaye et al., 2019a). Objectives of this quality improvement project were to research prevailing evidence-based literature on ERAS protocols, develop a facility specific protocol, and introduce the customized THA and TKA ERAS protocol to members of the perioperative team. Results of the post-implementation knowledge assessment demonstrated nurse anesthetists had a strong understanding of ERAS. Participants also indicated that the customized ERAS protocol would be implemented into practice. Obtaining surgeon and other perioperative staff buy-in to the protocol may further enhance patient safety and perioperative experience and reduce economic burden through decreased length of stay and postoperative complications.

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