Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Kathy Wheeler

Clinical Mentor

Dr. Pam Photiadis

Committee Member

Dr. Jan Odom-Forren



PURPOSE: The purpose of this study was to compare the efficiency of pre-admission testing (PAT) surgical clinic pre and post implementation of the APRN for patient assessment. Cancellation and delay occurrences for scheduled surgeries will be compared during two time periods on patients on the surgical schedule at Norton Women and Children’s Hospital (NWC).

METHODS: This study was a single-center, pre and post implementation retrospective comparative study of the impact of the NP led PAT unit at Norton Women and Children’s Hospital (NWC) in terms of delay and cancellation rates for day-of-surgery. The sample consisted of 411 patients for the pre-implementation period, February and March 2016, and 202 patients for the post-implementation period, February and March 2018.

RESULTS: Of the 411 pre-implementation charts, 225 resulted in delayed surgeries and 19 resulted in canceled surgeries. Of the 202 post-implementation charts, 109 resulted in delayed surgeries and 8 resulted in canceled surgeries.

CONCLUSION: Cancellation and delay rates of surgeries were not significantly decreased with the presence of the APRN across broad categories. However, when categories specifically under the influence of the NP were extracted there was a statistically significant reduction in delays. An incidental finding showed that the reason codes for delays and cancellations weighed heavily on the surgeon being late to the facility, as opposed to various other reasons, which negated the positive impact of the NP on total delay and cancellation rates.