Date of Award

Spring 2024

Document Type

Project – Full Written

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Candice Rome


Minimally invasive surgery (MIS) for transforaminal lumbar interbody fusion (TLIF) is becoming more frequently performed in ambulatory surgery centers (ASCs). Subsequently, patients are scheduled for an option to undergo a 23-hour observation which requires staff preparation. The preparation increases costs and creates a shortage during a standard daytime shift which can reflect negatively on patient care. Most patients elect to be discharged the same day, on account of experiencing minimal pain and seeking the comfort of their own home. The goal of this DNP project was to assess the necessity of scheduling a patient 23 hours for observation following a MIS TLIF and interviewing patients 24 to 48 hours postoperatively to allow patients to share personal experiences and perspectives. The reduction of unnecessary observation scheduling could improve nurse-patient ratios to benefit patient satisfaction and outcomes. The literature review consisted of assessing the benefits of ASCs with strategic selection of patient population, postoperative pain management, enhanced recovery after surgery (ERAS) protocols, and the relation of staffing shortages to patient care. The goal is to have 10 to 15 participants over 8 weeks. A total of seven participants were consented to participate. Limitations associated with the implementation were patients electing to opt out of participating and surgery cancellations due to various reasons: financial burden, insurance coverages, illnesses, or change in medical history. Five (71%) participants were overall satisfied with their decision for same-day discharge and clarified the reason was due to seeking comfort in their own homes. Two (28%) participants felt they would have benefited from the overnight stay. Future findings could benefit from seeking participants in an inpatient, as well as, an outpatient setting and for a longer duration.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License