Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Kristen L. Mauk


Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement patients the first four weeks post-operatively. Orem’s Self Care Deficit Theory and the Stetler’s Model of evidence utilization were used to guide the project. Patients undergoing knee replacement were randomly assigned to the Intervention group or Usual Care group. The Intervention group received a scheduled telephone call each week for the first 4-weeks postoperatively and a completion call in week five. Those in the Usual Care group received one telephone call following the 4-week postoperative period. Each telephone call included the completion of a standardized questionnaire developed by the project coordinator. Pain coaching was offered to each patient by the project coordinator. Data were collected regarding the assessment of pain, the use of pain medication, and secondary concerns such as constipation, nausea, or edema. An independent-sample t test comparing the mean scores of the Intervention and Usual Care groups found a significant difference between the means (t (23)=-2.578, p < .05), with the Intervention group reporting less pain. Data collected on secondary outcomes indicated constipation accounted for 24% of patient concerns and edema accounting for 5%. Telephone follow-up for post-operative patients is being adopted at the clinical site where the EBP project was completed.