Ambulatory surgery and prepared discharges. Effects on orthopedic patients and nursing practice.

Orthopedic medical and nursing practice has changed dramatically partly as a result of three trends: cost containment, technology, and consumer activism. Many orthopedic procedures previously requiring inpatient hospital stays are routinely performed on an outpatient, day-surgery basis. it is imperative that nurses working in the ambulatory surgery environment be diligent in practicing the nursing process to ensure comprehensive patient care. Patients requiring hospitalization for orthopedic procedures now have shorter lengths of stay. The brevity of stay means that a great deal of coordination, education, and referral efforts are necessary before the patient's discharge. Prepared discharge programs, with the nurse assuming the coordinator role, are one way of ensuring that patients are ready to make the transition from the hospital to their postdischarge environment.