Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Document Type

Poster

Publication Date

Fall 2025

Abstract

BACKGROUND: Periprosthetic joint infections (PJI) occur in 0.5%-3% of all total joint replacements. Preventing this complication is imperative to improve patient outcomes and reduce the financial burden of infections and readmissions. Studies show that silver-embedded dressings can reduce the incidence of joint infections by as much as 50%.

LOCAL PROBLEM: The setting for this project is a regional Level 1 trauma center in East Tennessee. The project site has had an increase in PJI over the last 2 years, from 1.34% in 2023 to 1.42% in 2024. This project aims to reduce the occurrence of PJI by 10% during the implementation period. The goal is 100% compliance with the use of silver-embedded dressings.

METHODS: The Evidence-Based Practice Improvement model (EBPI) was used for this project. Data were tracked on the number of total joint replacements completed, the number of patients returning due to infection, and the compliance percentage among physicians for 12 months pre-intervention and during intervention.

INTERVENTIONS: Silver-embedded dressings were applied to all total joint replacements. If a patient returned with a PJI, it was investigated whether a silver-embedded dressing had been used.

RESULTS: The rate of PJI dropped from 1.42% in 2024 to 0.29% for the first 8 months of 2025. This is a 79.6% reduction in PJI at the project site since implementation. There was 79.75% compliance with the use of the silver-embedded dressing. Lower compliance with dressing use was due to supply chain issues keeping dressings in stock, and to physicians occasionally using vacuum-assisted dressings.

CONCLUSIONS: Overall, using silver-embedded dressings reduced PJI, leading to better patient outcomes and cost savings. Continued use of the silver-embedded dressing is recommended, and the project site agrees.

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