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Faculty:: Paul M. Levy
Duration:: Full Day
Format:: Audio and Video
Copyright:: Oct 05, 2016

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Outline

Pre-operative Work-up

The pre-operative work-up is a vitally important part of the operative process. Not all patients with arthritis require surgery. Knowing the treatment options allows patients to make informed decisions about their care. Radiology examples will be included for case study discussion.

Diagnosis

Osteoarthritis
Bone Cancers
Recurrent Infections
Acute Injury, Falls, i.e.

Treatment Options

Exercise / Physical Therapy
Injections
Operative Treatments

Pre-operative Planning

Understanding the processes that need to take place prior to the surgery will help the patient better prepare for the surgery, allow for less patient anxiety and establish realistic goals and expectations.

Pre-operative Testing
Pre-operative Clearances
- Medical
- Cardiac
- Pulmonary
- Other/Individualized
Obtaining Consent
Pre-operative Education
- One-to-one education
- Online education
- Pre-operative joint classes

Surgical Procedures

Fixation
- Treatment for fractures that do not require joint replacement
Total Joint Replacement
- Hip
- Knee
- Shoulder
- Other Joints
  - The elbow, wrist, and ankle can also be replaced, but these surgeries are performed far less frequently. As well, there is currently a disk replacement surgery in study, but it is not yet FDA approved.
Megaprosthetic Replacements
- Replacement of both the joint and a portion of the surrounding bone
Joint Revisions

Immediate Post-Operative Care

Multi-modal Pain Management
- Oral vs. IV
- Nerve blocks
- Ambulation
- IV acetaminophen / NSAIDs
- Intra-operative steroid injection
- Age-related analgesia
- Opioid tolerance
Physical and Occupational Therapy
- Positioning
- Movement restrictions
- Exercises
- Assistive devices
Wound Care / Infection Prevention
- Dressings
- Antibiotics
VTE Prophylaxis
- Mechanical
- Pharmaceutical
Joint Commission S.C.I.P. (Surgical Care Improvement Project) Protocols
Surgical/Medical Complications

Post-acute Care and Follow-up

Discharge Planning
- Acute Rehab / Skilled Nursing / Home
- Follow-up appointments
- Home medications
Readmission/complications

Faculty

Paul M. Levy, MSN, BS, RN, ONC Related seminars and products: 2

PAUL M. LEVY, MSN, BS, RN, ONC, is a Registered Nurse with certification in Orthopaedic Nursing. Throughout his career, he has specialized in Orthopedics, specifically Total Joint Replacement Surgery, Sports Medicine, and Musculokeletal Oncology. Paul has worked on post-operative orthopedic units, serving as a staff nurse, charge nurse, preceptor, and mentor.

In Paul’s current role as Clinical Education Specialist for Orthopedics and Emergency Medicine at a hospital in Pittsburgh, PA, he is responsible for staff development and training, coordinates the Geriatric Fracture Program and the Crisis Management Training. In addition to his years of training experienced orthopedic staff, Paul has also developed an “Ortho for Non-ortho Nurses” program to help resource pool, staff, and new orthopedic nurses better understand orthopedic care. He also developed an Orthopedic Reference Guide for nurses to assist staff when orthopedic patients are admitted “off-service.”

Paul is committed to his area of expertise. He has spoken at the National Association of Orthopaedic Nurses Annual Congress, and other national and local conferences focusing on a variety of orthopedicrelated topics, and currently serves as the Chapter President of the Pittsburgh Chapter of the National Association of Orthopaedic Nurses.

Financial: Paul Levy has an employment relationship with UPMD St. Margaret. He receives a speaking honorarium from PESI, Inc.

Nonfinancial: Paul Levy is a member of the National Association of Orthopaedic Nurses. He is Chapter President for the Pittsburgh Chapter of the National Association of Orthopaedic Nurses. Mr. Levy indicates that he has a bias as an opponent of single payer healthcare delivery.

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Paul M. Levy – The Total Joint Replacement Patient: Supporting a Successful Journey