Doctor of Nursing Practice (DNP) Projects

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Doctor of Nursing Practice

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Post Master's DNP Completion

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orthopedic surgical older adult, frailty, Gerofit prehabilitation, physical activity


Celeste Surreira, DNP, MS, FNP-BC, NP-C, CNL

DNP Project Outside Member Name

Jessica Shanahan, MD, Medical Director, Preoperative Services (PATC)


Background: Frailty is a major cause of increased morbidity and mortality among older adults that undergo surgery. Prehabilitation programs are designed to reduce surgical complications in older adults. However, education about prehabilitation programs for older adults is lacking among health providers.

Purpose: The purpose of this DNP project was to increase knowledge about, and referrals to, a prehabilitation program among orthopedic providers at one Veterans Affairs Health Center.

Methods: A pre-and post-intervention survey design was used to assess change in knowledge of the Gerofit exercise program referral process in a Veterans Affairs Center. Additionally, a pre and post health record review was conducted to assess change in referrals to the Gerofit program.

Results: Nine providers participated in the online pre-intervention survey and received educational materials. Eight participants completed the post-intervention survey. Provider’s knowledge of the Gerofit exercise program increased post education. Referrals of patients with frailty ADL score > 7 for the Gerofit program also increased.

Conclusion: The educational intervention was successful. Initiating a referral to the Gerofit program prior to elective surgeries may improve outcomes for frail older Veterans.

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