Title

'Making a difference' a clinical pathway for hip fractures and the advance practice role in managing patients with minimal trauma hip fractures

Document Type

Journal Article

Publisher

Elsevier

Faculty

Faculty of Health, Engineering and Science

School

School of Nursing and Midwifery

RAS ID

17514

Comments

This article was originally published as: Pickles S.M., Coventry L.L., Glennon D.A., Twigg D.E. (2014). 'Making a difference' a clinical pathway for hip fractures and the advance practice role in managing patients with minimal trauma hip fractures. International Journal of Orthopaedic and Trauma Nursing, 18(4), 205-213. Original article available here

Abstract

Background: In 2006/2007 there were estimated over 16,500 patients with hip fractures in Australia, the majority (94%) were over 65 years. Patients with hip fractures nearly always require hospitalisation and surgery. Aim: The aim of this study was to assess the impact of the hip fracture clinical pathway on care of the hip fracture patient. Method: This study is a retrospective medical record audit of all minimal trauma hip fracture patients over 65 years in a large tertiary hospital over a three month period before and after implementation of the hip fracture clinical pathway. Results: For patients in the intervention group (. n = 28, mean 86.0 years) compared with the control group (. n = 33, mean 85.7 years) time to surgery was <24-h (92.9% vs. 51.5%, p = 0.001), the venous thromboembolism (VTE) risk assessment form was completed (21.4% vs. 0%, p = 0.004), VTE prophylaxis improved, fewer patients received no prophylaxis (0% vs. 33.3%, p = 0.001), pharmacological prophylaxis only (21.4% vs. 54.4%, p = 0.008) and more patients received pharmacological prophylaxis and graduated compression stockings (75.0% vs. 12.1%, p = 0.001) and were discharged with osteoporosis treatment calcium and vitamin D (35.7% vs. 6.1%, p = 0.008). Conclusion: Implementation of the hip fracture clinical pathway improved time to surgery (<24 h), VTE risk assessment and prophylaxis, and osteoporosis treatment on discharge.

DOI

10.1016/j.ijotn.2013.11.011

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