A new study explored the benefits of integrating nurse practitioners in orthopedic teams at major Canadian hospitals. Specifically, the research looked at how nurse practitioners are improving care at Burnaby Hospital.
Hip and knee replacement surgery is on the rise globally due to an aging population and increasing rates of musculoskeletal disorders. While some patients get their new hips and knees and are “good to go,” so to speak, others require more care.
A new study in the International Journal of Orthopaedic and Trauma Nursing, Enhancing orthopedic care: The impact of introducing nurse practitioners, concludes that having nurse practitioners (NPs) on orthopedic teams enhances patient outcomes and improves health care efficiency.
“Rather than being a substitute for doctors, nurse practitioners bring their own expertise to the health system,” says Sarah Crowe, the study’s co-author and nurse practitioner, clinician scientist, Fraser Health.
“Some patients have chronic conditions that can be addressed quickly by NP’s post-surgery – things like electrolyte imbalances and uncontrolled pain.”
NPs can assess, diagnose, discharge and order diagnostics and medications for patients.
“Being able to discharge patients without waiting for surgeons frees up more beds for additional surgeries and allows patients to recover at home earlier,” she says.
The study compared data from 2016 to 2018 and found that by adding nurse practitioners to the orthopedics team at Burnaby Hospital, monthly surgeries increased by 41.6 per cent, the average length of stay decreased for both hip and knee surgeries and the readmission rate post-discharge also decreased.
Staff surveys were positive, citing improved accessibility, bed utilization and timely treatment of medical issues.
Burnaby Hospital and Abbotsford Regional Hospital currently have NPs on their orthopedics teams and Surrey Memorial Hospital is recruiting.
NPs are embedded in other care teams in our region. Two NPs work in thoracic surgery at Surrey Memorial Hospital and Royal Columbian Hospital has a Perioperative Acute Care Team NP who assists patients to be as healthy as possible before surgery.
Abbotsford Regional Hospital and Surrey Memorial Hospital, where Sarah Crowe is based, also have NPs in their intensive care units. Internal Medicine across the region is also starting to include NPs as part of their care teams.
At Eagle Ridge and Peace Arch Hospitals, NPs are the Most Responsible Practitioner (MRP) in the Patient Access to Home (PATH) units.
“We are seeing a huge expansion in the breadth of work done by nurse practitioners,” adds Crowe.
“We provide a holistic approach where we consider how a patient’s economic and social status and education might fit into their experience and impact their health. We don’t replace anyone on the care team; we augment it. It is exciting and very rewarding work.”