Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2017


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E. Guzzetta, PhD, RN, FAAN


Problem: Surgical departments account for sizable budgets in hospitals. To ensure efficiency, optimal processes need to be maintained. The current practice for posting a surgical case is using surgeon estimated times (SETs), which only includes the reporting points of component 2 (C2) “incision” to “dressing.”

Objective: To analyze if there was a significant difference in minutes between actual operative times (AOT) and SET in patients undergoing outpatient general laparoscopic and inpatient orthopedic total joint surgery.

Methods: The facility is a level one trauma teaching center, with 371 beds, and a yearly surgical volume of 17,000 cases. This retrospective study used random sampling to compare and analyze the difference between AOT and SET, as well as actual operating room time (AORT): component one (C1) - “patient in OR to before incision” and component 3 (C3) - “after dressing to patient out of OR.” With a statistical power level of 0.8%, an alpha of 0.05%, a sample size of 120 surgical patients from each category was included.

Results: In hypotheses testing for outpatient general laparoscopic and inpatient orthopedic total joint patients, the results indicated that SET time (mean=105.8, + 31.6; mean=147, +36.4) in minutes was significantly greater than the AOT times (mean=75.5, + 30.6; mean=111.5, +23.4; p<0.001 for both analyses) in minutes, respectively.

Conclusions: The results uncovered a significant difference between AOT and SET and suggested over booking; whereas in AORT and SET, results suggested under booking. An interdisciplinary team will be assembled to develop an efficient scheduling system.

Open Access




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