The connection between strong social support and joint replacement outcomes.

A myriad of emotional, informational, and tangible needs can easily overwhelm patients as they seek to navigate a complicated surgical procedure. This article demonstrates that a dedicated family member or friend supporting their loved one before, during, and after joint replacement surgery measurably impacts quality and outcomes. The multidisciplinary, multihospital study team developed the following Opportunity Statement: "To define, measure, and implement a progressive family/friend support system across the continuum of care promoting optimal patient recovery after total joint arthroplasty." The team used the modified Groningen Orthopedic Social Support Scale to measure levels of social support and associated these levels with other patient outcomes.Analysis of 1722 observations across 4 hospitals found that patients with strong social support have shorter hospital stays, are more likely to be discharged home, to meet ambulation and transfer-out-of-bed targets, and to score hospital quality of care higher, and are more confident and ready to go home on discharge. Three presence intervals were also found to be significant predictors of key outcome measures: family/friend presence during the preoperative classes, in the preoperative holding area, and during the last physical therapy session. These intervals may serve as reasonable social support proxies for organizations desiring to measure social support to ultimately affect quality and outcomes.

Path to bariatric nurse certification: the practice analysis.

BACKGROUND: In 2005, the American Society for Metabolic and Bariatric Surgery (ASMBS) nursing membership embarked on a journey to develop a specialty certification program for nurses caring for morbidly obese and bariatric surgical patients. In keeping with the certification industry best practices, a practice analysis study was conducted to create an empirically sound foundation for the new nursing specialty certification examination. METHODS: Task force meetings, subject-matter expert interviews, and an external review process were implemented to create a definition of the specialty in terms of 4 domains of practice, 45 nursing tasks, and 54 knowledge areas. The definition encompassed the work of bariatric nurse coordinators, bariatric program directors, and floor nurses caring for morbidly obese and bariatric surgical patients. A survey was administered to 1084 nurses practicing in the specialty to validate the domains, tasks, and knowledge. RESULTS: Some differences in the time spent in each of the domains and tasks were noted for the survey respondents in the different job roles. Nevertheless, the respondents for all job roles rated the domains and tasks moderately or highly important in optimizing the outcomes for morbidly obese and bariatric surgery patients. In addition, most respondents agreed that the 54 knowledge areas were acquired during the first 2 years of practice in the specialty. CONCLUSION: The survey results validated a specialized body of nursing knowledge rooted in the tasks that define professional practice. The results are being used to guide the development of a certification program for nurses practicing in the specialty and to provide guidance for education and training initiatives.