Nursing Process Improvement Research-HCS/492


HCS/492 Need research information about a process improvement you would like to focus on in your Process Improvement and Change Project Presentation due in Week 7. Summarize your process for improvement and why it is needed in 350 words or less. This needs to coordinate with the previous paper I requested for week 7.


Nursing Process Improvement Research

There is need for process improvement at VA Hospital in order to reduce cases of post infections following total knee arthroplasty. Currently, the use of antibiotic prophylaxis is recommended following a total knee arthroplasty. The use of prophylaxis antibiotic has been proved as the most effective method of reducing post infections in total knee arthroplasty (Kalore, Gioe, & Singh, 2011). In particular, the addition of prophylaxis in the irrigation solution has been found to be more effective in reducing post infection in total knee arthroplasty. The use of antibiotic-laden cement in reducing post infections is discouraged as the method is ineffective. Use of chlorhexidine is also being encouraged since it gives better results compared to the traditional povidone-iodine in surgical field treatment. Chlorhexidine is considered a better sterilizer in surgical field treatment.

There is greater need to control the hospital environment where the surgical procedure is conducted. Research indicates that the operating room environment also determines the incidences of post infection in total knee arthroplasty (Kalore, Gioe, & Singh, 2011).  As such, control of the operating room environment is crucial. The number of individuals in the surgical room should be kept at a minimum to reduce risks of post infection. Leaving and reentering the room should also be restricted. The hospital can also consider using devices such as laminar flow or ultraviolet light to reduce infection rates during operation.

The identified processes of improvement are critical in total knee arthroplasty. Post infections in total knee arthroplasty is often difficult to treat or even diagnose. Diagnosis is a complex process which often involves bone scans, synovial fluid examinations, radiographs, histology, and other procedures which bring other complications. It is thus important to ensure that proper care is taken to avoid a post infection following a total knee arthroplasty.



Kalore, N. V., Gioe, T. J., & Singh, J. A. (2011). Diagnosis and Management of Infected Total    Knee Arthroplasty. The Open Orthopaedics Journal5, 86–91.


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