Orthopaedic Nurse Navigators and Total Joint Arthroplasty Preoperative Optimization: Obesity and Malnutrition-Part Four of the Movement Is Life Special ONJ Series.

Martha Kebeh, Chloe C Dlott, Donna Kurek, Jensa C Morris, Daniel H Wiznia

Journal: Orthopedic nursing 2024;43(2):75-83

PMID: 38546679

Abstract

Obesity and malnutrition affect many patients with osteoarthritis and can predispose patients to worse outcomes after total joint arthroplasty (TJA). However, these modifiable risk factors can be addressed in preoperative optimization programs driven by nurse navigators. Our aim is to provide resources and recommendations for nurse navigators when addressing obesity and malnutrition among TJA patients. In addition to discussions with nurse navigators regarding obesity and malnutrition, a literature review was conducted to assess the current practice standards for management. Nurse navigators often had difficulty implementing long-term interventions, but interventions in the literature included medical and bariatric treatments for obesity and more targeted assessment of nutrition status. These findings are incorporated into our recommendations for nurse navigators. Addressing obesity and malnutrition in preoperative optimization can contribute to improved outcomes, as has been demonstrated in current practice and in the literature.

Copyright © 2024 by National Association of Orthopaedic Nurses.

Address: Martha Kebeh, BA, Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.; Chloe C. Dlott, BS, Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.; Donna Kurek, MSN, RN, MHA, ONC, CMSRN, National Association of Orthopaedic Nurses and Movement is Life, Chicago, IL, and OrthoVirginia, Chesterfield, VA.; Jensa C. Morris, MD, Hospital Medicine Service, Yale New Haven Hospital, New Haven, CT, and Smilow Cancer Hospital, Yale New Haven Hospital, New Haven, CT, and Yale School of Medicine, New Haven, CT.; Daniel H. Wiznia, MD, Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
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