Learning Objective #1: Identify the role of nursing in coordinating the multidisciplinary team collaboration when new pain management regimens are initiated with total arthroplasty patients

Learning Objective #2: Describe the process of developing a nursing action plan to monitor the safety and efficacy of the subarachnoid narcotic and patient-controlled analgesia regimen

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There are many important nursing implications for the care of total arthroplasty patients who received a new subarachnoid and patient-controlled analgesia (PCA) narcotic protocol. This presentation will discuss the role of nursing in developing a multidisciplinary team approach for the management of a new pain regimen in total arthroplasty patients. The development of a nursing action plan evolved from paramount concerns regarding patient safety and efficacy of the concurrent use subarachnoid and PCA narcotics and issues surrounding staff preparation in caring for patients with such acuity. Spearheaded by nursing, the team comprised of nursing administrators, the orthopaedic nurse practitioner, the pain management clinical nurse specialist, the orthopaedic unit director, respiratory therapists, anesthesia providers and orthopaedic surgeons collaborated to ensure the successful and safe implementation of this new protocol. Activities included the implementation of continuous pulse oximetry, frequent vital sign and pain assessments, staff and patient/family education, and the initiation of a quality assurance and improvement study.