Date of Award

Spring 5-2022

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Carolyn Coleman

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. LaWanda Baskin

Committee Member 2 School

Leadership and Advanced Nursing Practice



The rates of total joint replacements, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA), are on the rise in the United States and are expected to rise further in the next 20 years (Singh et al., 2019). Implementing an ERAS protocol coupled with current orthopedic practices will decrease a vast number of postoperative issues such as length of hospital stays, the financial burden on the facility, and overall patient satisfaction. The DNP project proposed a multidisciplinary protocol to standardize the care of patients undergoing THA or TKA and identified if this surgical process would be adopted at a Veterans Administration Medical Center. A retrospective evaluation was used to assess the causes of prolonged hospital stays greater than three days of 15 consecutive patients undergoing THA or TKA and evaluated by staff involved in the surgical process. The survey results identified 15 patients with an extended length of stay due to the lack of orthopedic surgical knowledge and ERAS protocol among staff; additionally, after a thorough PowerPoint presentation, 97% of staff were in favor of the ERAS protocol being implemented. A standardized protocol was supported by leaders and the medical team and will aid in the implementation of the ERAS protocol to remedy the pitfalls in the surgical process of THA and TKA. This protocol will not only provide an effective postoperative solution to elderly veterans aged 55-85 years who have undergone TKA or THA, but it will potentially aid as a purposive reinforcement that would alleviate the financial burden on the medical facility.