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Health Services


Robert Hijazi


As the population ages and as people live longer, there is a growing demand for total hip and total knee procedures. Possible outcomes for these procedures is a postoperative joint infection (PJI) that can cause long postoperative lengths of stay (LOS) in the hospital. The PJIs can also negatively impact the quality of life for the patient. Using the roadmap of the continuous quality improvement theory, the purpose of this quantitative study was to examine the relationship between the independent variables (joint education class participation, body mass index [BMI], A1c, and smoking) and dependent variables (PJI and LOS). To evaluate the relationship with PJI, a logistical regression analyzed the sample population of 1,216 patients and indicated a relationship between joint education class attendance and PJI among total hip patients, but not total knee patients when controlling for the other variables. The regression also indicated a significant relationship between BMI and smoking and PJIs, but it did not show a relationship between A1c/diabetes and PJI. To evaluate the relationship between joint class education and LOS a Poisson regression indicated that those who did not attended the joint education class, whether they had total hips or total knees, had a longer postoperative LOS. The implications for positive social change involve providing information to physicians and administrators regarding the effectiveness of the total joint education class in improving outcomes. This information could be used to justify the need for patient compliance with the class and/or the possible need for additional resources to support the total joint education program.

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