title: Nurse-led orthopaedic clinic in total joint replacement.
abstract: OBJECTIVE
  To introduce the practice of a nurse-led orthopaedic clinic for managing stable patients after total hip or knee replacement and to evaluate its efficacy.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A public hospital in Hong Kong.
  
  
  METHODS
  Patients who had stable primary total knee replacement or total hip replacement done for longer than 2 years were managed in a nurse-led total joint replacement pilot clinic.
  
  
  RESULTS
  From July 2012 to March 2014, 431 patients (including 317 with total knee replacement and 114 with total hip replacement) were handled, and 408 (94.7%) nurse assessments were independently performed. Six cases of prosthesis-related complications were diagnosed. One patient was hospitalised for prosthetic complications within 3 months after follow-up. The satisfaction rate was 100%. From November 2012 to April 2013, an advanced practice nurse, one resident specialist, and one associate consultant independently charted Knee Society Knee Score or Harris Hip Score for the patients attending preoperative assessment clinic to check the inter-observer reliability. Overall, 23 patients with 37 knees and 11 patients with 17 hips were examined. The mean correlation coefficient between assessments by the associate consultant and advanced practice nurse was 0.912 for Knee Society Knee Score, and 0.761 for Harris Hip Score. The advanced practice nurse could achieve better or equally good correlation with associate consultant when compared with the correlation between resident specialist and associate consultant (0.866 and 0.521 for Knee Society Knee Score and Harris Hip Score, respectively) and with international standard.
  
  
  CONCLUSIONS
  Nurse-led total joint replacement clinic was safe, reliable, and well accepted by patients.
authors.affiliation: Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong.
authors.forename: Jason C H
authors.initials: JC
authors.lastname: Fan
authors.affiliation: Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong.
authors.forename: Carmen K M
authors.initials: CK
authors.lastname: Lo
authors.affiliation: Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong.
authors.forename: Carson K B
authors.initials: CK
authors.lastname: Kwok
authors.affiliation: Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong.
authors.forename: K Y
authors.initials: KY
authors.lastname: Fung
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000451:nursing* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000451:nursing* / Q000706:statistics & numerical data; D003266:Continuity of Patient Care; D006723:Hong Kong; D006779:Hospitals, Public; D006801:Humans; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications; D057184:Practice Patterns, Nurses' / Q000592:standards; D011795:Surveys and Questionnaires
keywords: Arthroplasty, replacement, hip; Arthroplasty, replacement, knee; Nurses