Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




Dr. Brian Garrett, DNP, CRNA

First Committee Member

Dr. Joy Shoemaker, DNP, RN, APRN.CNP, FNP-C, CNE

Second Committee Member

Dr. Amy Bishop, DNP, AGCNS


Evidence-Based Practice, Anesthesia, Arthroplasty

Subject Categories

Medicine and Health Sciences



Total knee and hip arthroplasty are the two most common orthopedic surgeries in the United States. Traditional perioperative practice is multidisciplinary, with each professional, including anesthesia, making decisions based on their current knowledge or past experience. Postoperative complications pose a threat to any patient undergoing a surgical procedure. Enhanced Recovery After Surgery (ERAS) protocols were developed to streamline best practice guidelines during the perioperative period. ERAS pathways aim to decrease postoperative complications, accelerate recovery after surgery, decrease narcotic use and promote early mobilization and discharge from the hospital. The aim of this project is the development of evidence-based practice (EBP) guidelines using recommendations from ERAS protocols. The EBP guidelines include preoperative education, patient optimization and euvolemic fluid management. During the intraoperative period, the EBP guideline includes opioid-sparing anesthetic, spinal anesthesia, and/or intraarticular block. The EBP guideline recommends scheduled medications preoperatively and postoperatively. In the postoperative period, the EBP guideline recommends early mobilization. Project managers will implement the EBP guideline at an urban mid-western level one hospital. Progress of implementation and staff adherence to guidelines will be tracked electronically. Data will be collected in excel spreadsheets and evaluated.

Keywords: ERAS, TKA/THA, Evidence-based practice guidelines

Acknowledgement 1


Acknowledgement 2


Licensing Permission

Copyright, all rights reserved. Fair Use



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