Materiały źródłowe

• #1 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Hip fractures are common causes of disability, with mortality rates reaching 30% at one year. […] Operative management within 24 to 48 hours of the fracture optimizes outcomes. […] Pre- and postoperative antistaphylococcal antibiotics are given to prevent joint infection. […] Early postoperative mobilization, followed by rehabilitation, improves outcomes. […] Subsequent care focuses on prevention, with increased physical activity, home safety assessments, and minimizing polypharmacy. […] An interdisciplinary care team, including orthopedic surgeons, hospitalists, dietitians, geriatric services, and physical and occupational therapists, reduce postoperative complications and in-hospital mortality and improve functional status. […] Hip fractureassociated delirium is a common complication in hospitalized patients, both pre- and postoperatively.

• #1 Hip Fracture: Diagnosis, Treatment, and Secondary Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p945.html

  Hip fractures cause significant morbidity and are associated with increased mortality. […] Patients with hip fractures have pain in the groin and are unable to bear weight on the affected extremity. […] Most fractures are treated surgically unless the patient has significant comorbidities or reduced life expectancy. […] Patients should receive prophylactic antibiotics, particularly against Staphylococcus aureus, before surgery. […] In addition, patients should receive thromboembolic prophylaxis, preferably with low-molecular-weight heparin. […] Rehabilitation is critical to long-term recovery. […] Unless contraindicated, bisphosphonate therapy should be used to reduce the risk of another hip fracture. […] Some patients may benefit from a fall-prevention assessment. […] The family physician’s role involves multiple objectives: identify patients at increased risk of a hip fracture, promptly diagnose a hip fracture, facilitate long-term rehabilitation, reduce the risk of another hip fracture, and manage comorbid conditions.

• #1 Hip fracture – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hip-fracture/diagnosis-treatment/drc-20373472

  A health care provider can often diagnose a hip fracture based on symptoms and the abnormal position of the hip and leg. An X-ray usually will confirm the fracture and show where the fracture is. […] Treatment for hip fracture usually involves a combination of prompt surgical repair, rehabilitation, and medication to manage pain and to prevent blood clots and infection. […] The type of surgery generally depends on where and how severe the fracture is, whether the broken bones aren’t properly aligned (displaced), and your age and underlying health conditions. Options include: […] A hip fracture can be repaired with the help of metal screws, plates and rods. In some cases, artificial replacements (prostheses) of parts of the hip joint may be necessary. […] Physical therapy will initially focus on range-of-motion and strengthening exercises. Depending on the type of surgery and whether there’s help at home, going to an extended care facility might be necessary. […] An occupational therapist teaches techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking. An occupational therapist will determine if a walker or wheelchair might be needed to regain mobility and independence.

• #1 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  Providing care to older people following trauma must follow the same principles as for all age groups, using the ABCDE approach. […] A hip fracture is diagnosed by the symptoms and verified with X-rays; these may be supplemented with MRI or CT to establish diagnosis. […] Caring for patients following hip fracture is an everyday event for care staff, but, for the patient, it is a life-changing event with severe and frightening consequences. […] The aim of preoperative care is to prepare the patient for surgery in a manner that avoids the development of complications of immobility and surgery. […] Pain assessment, evaluation, reassessment and appropriate administration of analgesia should be central to routine care. […] Mobilising the patient soon after surgery has proven to be beneficial in prevention of the complications of mobility and in assisting recovery.

• #1 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  Patients with hip fracture are susceptible to foreseeable and potentially avoidable complications. An interprofessional team approach to care that uses evidence-based strategies for prevention, early detection, and proactive care to avoid complications is key to optimal patient outcomes. […] The majority of these patients will enter the hospital via the ED. Consideration must be given to providing an environment that is sensitive to the care needs of this vulnerable population. […] Nurses can play an important role in advocating for timely access to surgery. […] A. Determine the patients preadmission cognitive status and cognitive presentation on admission using a standardized tool and information from family. […] A. Assess for malnutrition on admission using a standardized screening tool.

• #1 Hip Fracture Nursing Care Plan

  https://rnspeak.com/hip-fracture-nursing-care-plan/

  Hip fractures are among the most frequent fractures presented to the emergency department and orthopedic trauma teams. […] An estimated 340,000 hip fractures occur each year. […] The majority of hip fractures result from falls in the older adult population. […] Nursing interventions for a client diagnosed with hip fracture include the prevention of falls, strengthening of the bone quality, and lifestyle modifications. […] Effective pain management is critical since the pain has been found to increase morbidity from hip fractures. […] Severe pain significantly increases delirium in older adult clients and is associated with longer time to mobilization, increased hospital stay, and decreased functional outcomes. […] The blood supply to the femoral head plays an important role when deciding the management of hip fractures. […] The overreaching health care challenge after hip fracture and surgery is to maximize mobility and encourage older adults to return to their usual activities of daily living and engage in physical activity.

• #1 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Aggressive pain control with higher doses of opiates and/or regional blocks are associated with lower delirium rates. […] Overall, evidence suggests that that aggressive pain control is an important goal in managing hip fracture patients. Frequent pain assessment, especially in patients with dementia, and regular use of parenteral or oral opiates is generally required. […] Therefore, close attention to prevention of this potentially life-threatening complication is required. […] Practice guidelines released in 2012 from the American College of Chest Physicians recommend a minimum of 10-14 days of prophylaxis with either low molecular weight heparin, fondaparinux, low-dose unfractionated heparin, adjusted dose warfarin, aspirin or an intermittent pneumatic compression device. […] Delirium occurs in a quarter of patients without baseline dementia, and over half of dementia patients who experience a hip fracture.

• #1 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #1 Fracture Nursing Care Plans: 11 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/fracture-nursing-care-plans/

  Patients with fractures are at risk for peripheral neurovascular dysfunction due to the potential compression of the nerves and blood vessels in the affected limb. […] As a nurse, it is important to assess and monitor the patients peripheral neurovascular status, through regular evaluations and interventions such as repositioning and splinting, to prevent and manage this risk. […] Patients with fractures are at risk for impaired gas exchange due to pain and discomfort leading to shallow breathing, decreased lung expansion, and decreased oxygenation of the bloodstream. […] As a nurse, it is important to regularly assess and promote deep breathing exercises, as well as encourage mobility and physical activity to prevent and manage this risk. […] Patients with fractures are at risk for impaired skin integrity due to immobility and decreased physical activity, which can lead to pressure ulcers and other skin breakdown.

• #1 Hip Fracture: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hip-fracture-nursing-diagnosis-care-plan/

  Nursing Diagnosis: Risk for Infection […] The surgical site must be kept clean and dry at all times. Educate the patient and family members on how to provide appropriate wound care at discharge. […] Infection prevention includes strict hand hygiene. Always wash hands when visibly soiled and use alcohol-based hand rubs before touching the patient. […] Antibiotic therapy is often provided for patients following surgery to prevent infection and promote wound healing.

• #1 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures

  Hip fractures can be very painful. For this reason, prompt surgical treatment is recommended. Treating the fracture and getting the patient out of bed as soon as possible will help prevent medical complications such as bed sores, blood clots, and pneumonia. In very old patients, prolonged bed rest can also lead to disorientation, which makes rehabilitation and recovery much more difficult. […] Most hip fractures require surgical treatment within 1 to 2 days of injury. Only a very small group of nondisplaced fractures in healthy patients can be treated without surgery, while a separate small group of patients may be too sick to safely have surgery. […] Surgical treatment is required to relieve the acute pain of the fracture and to allow the patient to get out of bed. Having surgery as soon as possible can lessen the risk of complications.

• #1 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Hip fractures are best treated with a team approach. You and your family are an important part of your care team, especially when it comes to decisions before, during and after your treatment. […] After your surgery, you’ll be moved to the Post Anesthesia Care Unit (PACU), also called the recovery room. You’ll stay there until the anesthesia wears off and you are stable. This usually takes a few hours. You will then be moved back to your hospital room. […] It is important that you don’t stay in bed too long after your surgery. Physical therapy will begin the day of your surgery or the next morning, depending on the time of day your surgery is scheduled. Your goal is to increase your activity a little each day to build your strength and continue your recovery outside of the hospital. […] Even with medication, some pain is normal after surgery. You will receive pain medication by taking pills or through an IV. Ice packs can also be used to help lessen pain and swelling. The goal is to reduce your pain enough so that you can do the physical therapy exercises that will help you heal and regain as much independence as possible.

• #1 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  Getting out of bed and moving can reduce the risk of developing these complications. […] The best treatment is to prevent bed sores in the first place. […] The best way to prevent pressure ulcers is to get you out of bed and moving when possible. […] There are many ways to reduce the risk of DVT, but the most effective is getting you moving as soon as possible. […] Your dietitian will assist you in planning menu choices to ensure you have the proper diet. […] In order for you to return to your highest level of function as quickly as possible, it is imperative that you have adequate pain control to be able to move around throughout the day. […] Your physical therapist will begin with personalized exercises with you to not only help move the hip, but also to increase your strength and range of motion in your hip. […] After this type of injury you will need an assistive device to help you walk, such as a rolling walker, a 3-in-1 commode, or tub transfer bench.

• #1 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  The annual number of hip fractures worldwide is expected to exceed 6 million by 2050. Currently, nearly 50% of hip fracture patients will develop at least one short-term complication including infection, delirium, venous thromboembolism (VTE), pressure ulcers or cardiovascular events. […] This paper summarizes current evidence for postoperative interventions attempting to improve these outcomes, including pain management, anemia management, delirium prevention strategies, VTE prophylaxis, rehabilitation type, nutritional supplements, anabolic steroids and secondary fracture prevention. […] In general, good quality evidence supports routine use of VTE prophylaxis, and moderate quality evidence supports multifactorial delirium prevention protocols, and a conservative transfusion strategy.

• #1 Home | UCSF Hip Fracture Protocol

  https://hipfracture.ucsf.edu/home

  All patients with hip fractures should receive timely, effective, multi-modal analgesia. As part of this the Departments of Anesthesia and Perioperative Care, Emergency Medicine, Orthopedic Surgery recommend all patients receive an ultrasound-guided fascia iliaca block (FIB) as soon as appropriate and possible as this has been shown to decrease pain, need for opioids, and assist in timely transfer to OR. […] DVT prophylaxis: start POD #1. […] Start Calcium Carbonate 1250mg daily on discharge (alternatively can order extra strength Tums twice daily). […] If PCP not able to be contacted or to manage osteoporosis, Geriatrics or medicine consult places 'referral to orthopaedics-skeletal health’ for follow up 1-2 months after discharge.

• #1 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Therefore, delirium prevention efforts become extremely important after hip fracture. […] Thus, it appears that careful attention to medical and geriatric issues with an interdisciplinary team is an effective strategy in preventing delirium in this population. […] Anemia, typically defined as a hemoglobin level 10g/dl, is present in approximately half of hip fracture patients at hospital admission, and 90% postoperatively. […] Given the potential for adverse events with transfusion, a conservative strategy of transfusing only when symptomatic, or in high-risk patients with hemoglobin 8g/dl is recommended. […] Rehabilitation is a cornerstone in efforts to reduce rates of ambulatory and functional impairment, but limited evidence is available to inform on the optimal venue for such therapy.

• #1

  https://link.springer.com/article/10.1007/s10354-013-0247-8

  The implementation of integrated care pathways and geriatric care intervention programs for patients with hip fracture in emergency departments (ED) is a challenge in most cases. […] A well-managed admission of older people with hip fracture to hospital which is based on clinical assessment can prevent adverse effects. […] The recommended multidimensional holistic approach from admission to discharge in the ED can meet patients expectations and ensure their right of remaining autonomous as well as receiving appropriate, equal and fair treatment with dignity and respect. […] Discharge planning begins with admission to hospital. This is very important for good discharge planning and for the post-dromal phase of hip fracture.

• #1 Hip Fracture Nursing Care Plan Guide – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/hip-fracture-nursing-care-plan-guide/

  A good nursing care plan for hip fracture is key for patient care. This plan covers the steps for looking, helping, and checking patients, using best practices. This helps patients the most. […] After surgery, patients with hip fractures need special care. This care is all about making sure they manage pain, move around, and avoid problems. Nurses are very key in this care, using a full hip fracture care plan. […] Helping patients learn is key to getting better and staying that way after a hip fracture. We teach about moving safely, taking medicine right, and the different types of help that can make recovery easier. […] Managing pain is very important in treating a hip fracture. It helps the patient feel better. This makes it easier for them to get well. The methods used depend on what the person needs.

• #1 Discharge Instructions for Hip Fracture Surgery | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hip-fracture-surgery

  You must take care of your hip as you recover at home or in a rehabilitation facility. […] You must also see your healthcare provider for follow-up visits as you slowly return to activity. […] Take your pain medicine exactly as advised. […] Get up and carefully move around to ease pain. […] If you got an artificial hip joint, tell all your healthcare providers including your dentist about the joint before any procedure. […] Prevent infection by washing your hands often. […] Call your healthcare provider right away if you think you may have an infection. […] Check your incision daily for redness, soreness, or drainage. […] Wait 7 days after your surgery to start showering. […] Use chairs with arms and sit with your knees slightly lower than your hips. […] Use a raised toilet seat for 6 weeks after surgery.

• #1 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures

  Most patients are able to get of bed and start physical therapy the day after surgery. It is important to begin moving as soon as possible. This helps prevent medical complications, such as blood clots, pneumonia, and bed sores. For older patients, it also helps prevent disorientation and deconditioning. […] During recovery, you will work with physical and occupational therapists. They will give you exercises and tell you how much weight you can put on your leg. They will also show you how to manage the activities of daily living, such as bathing and dressing. […] Your doctor and nurses will work with you to help reduce your pain. Typically, you will be given medicine through an IV in the first few hours after surgery. Then you will be switched to oral pain medicine. This may take the form of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or over-the-counter pain medication such as acetaminophen. Your doctor may also use a combination of these medications to manage pain. […] Many patients go home after hip fracture surgery, but some will need short-term care in a rehabilitation facility. Usually, these patients are elderly or have no caregivers at home.

• #1 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Continue your physical therapy. Do any exercises that your doctor or physical therapist recommend and continue to go to physical therapy as prescribed. Staying active will help strengthen your bones. Exercise is the most important thing you can do to ensure the best recovery possible. […] From discharge through recovery and beyond, there are things you can do to ensure you stay in your best health and prevent injuries in the future.

• #1 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Although evidence supporting a specific type or venue of rehabilitation after hip fracture is lacking, a sensible approach in my opinion is to provide the most intensive regimen tolerated by the patient, addressing both physical and instrumental tasks with an interdisciplinary team. […] Secondary fracture prevention, in particular bisphosphonate therapy, reduces subsequent fracture rates and mortality and should be considered in all hip fracture patients. […] Because of the complexity of care after hip fracture, models of care including clinical pathways, geriatrics consultation or specialized wards may facilitate high quality, interdisciplinary care and therefore improve outcomes.

• #1 Nursing Care Plan for Hip Fracture

  https://www.registerednursern.com/nursing-care-plan-for-hip-fracture/

  This nursing care plan is for patients who have a hip fracture. A hip fracture, as known as a femoral fracture, occurs on the proximal end of the femur. The number one cause of hip fractures is related to osteoporosis which causes weak bones. Many patient who have hip fractures report feeling the bone give away and then they fall. Another common reason for a hip fracture is due to a high trauma accident like car wreck. Majority of patients plagued with hip fractures are elderly women (ages 70s or older). […] Patient who have hip fractures will present with a lower extremity that looks shorter than the other and the extremity will be externally rotated. Hip fractures are easily diagnosis with a AP and Lateral x-ray or MRI. Most hip fractures are fixed with surgery. […] A 76 year old female is admitted with a hip fracture. The patients family is with her. The patients family states that their mother was trying to walk up a hill in their back yard and all of a sudden fell down. The patient lives with her children. You note on assessment the patient right leg looks shorter than her left and is externally rotated.

• #1 Hip fracture 1: identifying and managing risk factors | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/hip-fracture-1-identifying-and-managing-risk-factors-10-12-2018/

  Hip fractures are common, and associated with high risks of morbidity and mortality. […] Within the multidisciplinary team, nurses play an important role in assessing the risk of hip fracture, identifying modifiable risk factors and reducing the potential for harm. […] Nurses are often ideally placed to provide both psychological support and education to help patients cope with their diagnosis, as well as to advise on how to optimise bone health to reduce the risk of further fractures. […] Falls are a significant risk factor for hip fracture, so it is important that nurses are vigilant for predisposing factors and reduce the risk of falls by using enhanced supervision and the expertise of the multidisciplinary team. […] A risk assessment can be performed for anyone considered to be at risk of hip fracture; identifying at-risk patients in a consistent and systematic way could prevent up to 25% of hip fractures.

• #1 Hip fracture – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hip-fracture/symptoms-causes/syc-20373468

  A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. […] To avoid falls and to maintain healthy bone: […] Exercise to strengthen bones and improve balance. Weight-bearing exercises, such as walking, help maintain peak bone density. Exercise also increases overall strength, decreasing the risk of falling. Balance training also is important to reduce the risk of falls since balance tends to deteriorate with age. […] A hip fracture can reduce independence and sometimes shorten life. About half the people who have a hip fracture aren’t able to regain the ability to live independently.

• #1 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #1 Hip Fracture Nursing Care Plan Guide – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/hip-fracture-nursing-care-plan-guide/

  Nurses teach patients to move safely after a hip fracture. This includes showing how to use walking aids correctly. They start patients slowly back on their feet, and they guide them in exercises to get strong again. […] Many different experts are needed to care for hip fractures properly. Working together, they make sure the patient gets well. This team might include doctors, physical therapists, and diet experts. […] Nurses focus on a few main things to help those with hip fractures. They work on pain, making sure the patient is safe, getting them moving again, and avoiding problems like infections. But they also give a lot of emotional help and teach them about their care. […] It’s key to stop possible hip fractures, especially for older folks. Being active in preventing falls means less future injuries. This guide helps combine tactics for fall protection and keeping bones strong.

• #1 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  The experienced team at Memorial Hermann will focus specifically on you and your family. […] Nursing Team (Registered Nurse, Licensed Vocational Nurse, Patient Care Assistants) – Before, during and after your surgery, you can expect to meet different nurses who perform many different jobs. […] Your physical therapist is trained to help you gain strength and motion after your surgery and will help ensure that you do your exercises correctly. […] Your occupational therapist is trained to help you learn to safely and effectively perform activities of daily living, such as bathing and dressing. […] Managing your pain safely and effectively is important to us. […] If you are having pain, please report it to your caregiver immediately. […] Complications can occur after a hip fracture and, generally, are related to immobilization.

• #1 Hip fracture 1: identifying and managing risk factors | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/hip-fracture-1-identifying-and-managing-risk-factors-10-12-2018/

  It is essential that nurses identify risk factors and actively seek to reduce the potential for harm. […] Nurses in all settings are ideally placed to identify people at risk of hip fracture and facilitate collaboration with multidisciplinary and specialist teams. […] They contribute greatly to risk assessment, education and health promotion, and some initiate and monitor medical and lifestyle interventions.

• #1 Hip fracture care | Leading Better Value Care | Agency for Clinical Innovation

  https://aci.health.nsw.gov.au/statewide-programs/lbvc/hip-fracture-care

  A hip fracture is a break occurring at the top of the thigh bone (femur), near the pelvis. It is a significant injury in an older person and is associated with significant morbidity, loss of function and mortality. Sub-optimal management can result in avoidable complications, prolonged hospitalisation and poorer patient outcomes. […] The aims of the initiatives are to: reduce unwarranted clinical variation, improve patient assessment, management and experience, ensure effective and efficient care. […] Read about the four clinical priority areas for hip fracture care: timely assessment and treatment of pain, surgery within 36-hours of arriving at hospital (if appropriate), coordinated orthopaedic and geriatric services, patients getting back on their feet within a day if possible. […] Explore options for different organisational models to tailor clinical services for your local requirements: structured orthogeriatric service, coordinated care applying orthogeriatric principles. […] Consumer fact sheet: Hip fracture care, Clinician fact sheet: Hip fracture care, Orthogeriatric hip fracture care.

• #2 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Hip fractures are common causes of disability, with mortality rates reaching 30% at one year. […] Operative management within 24 to 48 hours of the fracture optimizes outcomes. […] Pre- and postoperative antistaphylococcal antibiotics are given to prevent joint infection. […] Early postoperative mobilization, followed by rehabilitation, improves outcomes. […] Subsequent care focuses on prevention, with increased physical activity, home safety assessments, and minimizing polypharmacy. […] An interdisciplinary care team, including orthopedic surgeons, hospitalists, dietitians, geriatric services, and physical and occupational therapists, reduce postoperative complications and in-hospital mortality and improve functional status. […] Hip fractureassociated delirium is a common complication in hospitalized patients, both pre- and postoperatively.

• #2 Nursing Care Plan for Hip Fracture

  https://www.registerednursern.com/nursing-care-plan-for-hip-fracture/

  This nursing care plan is for patients who have a hip fracture. A hip fracture, as known as a femoral fracture, occurs on the proximal end of the femur. The number one cause of hip fractures is related to osteoporosis which causes weak bones. Many patient who have hip fractures report feeling the bone give away and then they fall. Another common reason for a hip fracture is due to a high trauma accident like car wreck. Majority of patients plagued with hip fractures are elderly women (ages 70s or older). […] Patient who have hip fractures will present with a lower extremity that looks shorter than the other and the extremity will be externally rotated. Hip fractures are easily diagnosis with a AP and Lateral x-ray or MRI. Most hip fractures are fixed with surgery. […] A 76 year old female is admitted with a hip fracture. The patients family is with her. The patients family states that their mother was trying to walk up a hill in their back yard and all of a sudden fell down. The patient lives with her children. You note on assessment the patient right leg looks shorter than her left and is externally rotated.

• #2 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  Providing care to older people following trauma must follow the same principles as for all age groups, using the ABCDE approach. […] A hip fracture is diagnosed by the symptoms and verified with X-rays; these may be supplemented with MRI or CT to establish diagnosis. […] Caring for patients following hip fracture is an everyday event for care staff, but, for the patient, it is a life-changing event with severe and frightening consequences. […] The aim of preoperative care is to prepare the patient for surgery in a manner that avoids the development of complications of immobility and surgery. […] Pain assessment, evaluation, reassessment and appropriate administration of analgesia should be central to routine care. […] Mobilising the patient soon after surgery has proven to be beneficial in prevention of the complications of mobility and in assisting recovery.

• #2 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #2 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Aggressive pain control with higher doses of opiates and/or regional blocks are associated with lower delirium rates. […] Overall, evidence suggests that that aggressive pain control is an important goal in managing hip fracture patients. Frequent pain assessment, especially in patients with dementia, and regular use of parenteral or oral opiates is generally required. […] Therefore, close attention to prevention of this potentially life-threatening complication is required. […] Practice guidelines released in 2012 from the American College of Chest Physicians recommend a minimum of 10-14 days of prophylaxis with either low molecular weight heparin, fondaparinux, low-dose unfractionated heparin, adjusted dose warfarin, aspirin or an intermittent pneumatic compression device. […] Delirium occurs in a quarter of patients without baseline dementia, and over half of dementia patients who experience a hip fracture.

• #2 Hip Fracture – Fractures – Fundamentals of Nursing – Picmonic for Nursing RN

  https://www.picmonic.com/pathways/nursing/courses/standard/fundamentals-of-nursing-273/fractures-1447/hip-fracture_2116

  The patient may experience muscle spasms in the affected leg, especially when attempting to move the fractured hip. […] The patients leg will also be noticeably shorter on the affected side. […] The patient will report pain and tenderness in the affected leg/hip. Pain should be managed using analgesic medication. […] Bucks traction is a type of skin traction used to immobilize and maintain alignment of the lower extremities. This type of traction may be used for 24 to 48 hours prior to surgery in an effort to stabilize the patient and decrease muscle spasm. […] Pain management is an important aspect of patient care. Analgesics should be administered to reduce pain caused by muscle spasms prior to surgery and again after surgery to manage post-op pain. […] Surgery to repair a fractured hip may involve internal fixation, partial, or total hip replacement. […] Complications of a fracture hip include avascular necrosis. This condition causes death of bone tissue due to insufficient blood supply to the affected area.

• #2 Hip Fracture: Diagnosis, Treatment, and Secondary Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p945.html

  Hip fractures cause significant morbidity and are associated with increased mortality. […] Patients with hip fractures have pain in the groin and are unable to bear weight on the affected extremity. […] Most fractures are treated surgically unless the patient has significant comorbidities or reduced life expectancy. […] Patients should receive prophylactic antibiotics, particularly against Staphylococcus aureus, before surgery. […] In addition, patients should receive thromboembolic prophylaxis, preferably with low-molecular-weight heparin. […] Rehabilitation is critical to long-term recovery. […] Unless contraindicated, bisphosphonate therapy should be used to reduce the risk of another hip fracture. […] Some patients may benefit from a fall-prevention assessment. […] The family physician’s role involves multiple objectives: identify patients at increased risk of a hip fracture, promptly diagnose a hip fracture, facilitate long-term rehabilitation, reduce the risk of another hip fracture, and manage comorbid conditions.

• #2 Care plan help for hip fracture – Nursing Student Assistance

  https://allnurses.com/care-plan-help-hip-fracture-t518289/

  Nursing dx 1: Right Hip Fracture r/t musculoskeletal impairment […] Interventions: q2h turn, monitor for skin breakdown, not sure about others […] Nursing dx 2: I am having a hard time coming up for this one related to the pneumonia. […] Nursing Interventions: Monitor rate, depth, and ease of respirations, Monitor for signs of hyperventilation, Monitor O2 sats […] Nursing dx 3: Chronic confusion r/t alzheimer’s disease. […] Care plans are all about the assessment…of the patient. Let the patient/patient assessment drive your diagnosis. […] The medical diagnosis is the disease itself. It is what the patient has not necessarily what the patient needs. […] Care plan reality: The foundation of any care plan is the signs, symptoms or responses that patient is having to what is happening to them.

• #2 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures/

  Hip fractures can be very painful. For this reason, prompt surgical treatment is recommended. Treating the fracture and getting the patient out of bed as soon as possible will help prevent medical complications such as bed sores, blood clots, and pneumonia. […] Most hip fractures require surgical treatment within 1 to 2 days of injury. Only a very small group of nondisplaced fractures in healthy patients can be treated without surgery, while a separate small group of patients may be too sick to safely have surgery. […] Most patients are able to get of bed and start physical therapy the day after surgery. It is important to begin moving as soon as possible. This helps prevent medical complications, such as blood clots, pneumonia, and bed sores. […] During recovery, you will work with physical and occupational therapists. They will give you exercises and tell you how much weight you can put on your leg. They will also show you how to manage the activities of daily living, such as bathing and dressing.

• #2 Recovery at Home After a Hip Fracture | Best Care

  https://bestcaremn.com/blog/healing-after-the-fall-recovery-at-home-after-a-hip-fracture/

  Additionally, many older adults recovering from a hip fracture find the services of a home health personal care assistant to be invaluable. […] The two main challenges a caregiver faces when they are tending to the needs of a family member who is recovering from a hip fracture are ensuring they have enough exercise and that the older person is receiving enough nutrition in their diet. […] Once your loved one has returned home, you’ll need to show them the changes you have made in the home. […] Additionally, it is very important for the person to take pain medication as directed because if their pain flares up, the person is going to have difficulty doing their exercises and moving around their home. […] One of the dangers people face after a hip fracture is the formation of blood clots.

• #2 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures

  Most patients are able to get of bed and start physical therapy the day after surgery. It is important to begin moving as soon as possible. This helps prevent medical complications, such as blood clots, pneumonia, and bed sores. For older patients, it also helps prevent disorientation and deconditioning. […] During recovery, you will work with physical and occupational therapists. They will give you exercises and tell you how much weight you can put on your leg. They will also show you how to manage the activities of daily living, such as bathing and dressing. […] Your doctor and nurses will work with you to help reduce your pain. Typically, you will be given medicine through an IV in the first few hours after surgery. Then you will be switched to oral pain medicine. This may take the form of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or over-the-counter pain medication such as acetaminophen. Your doctor may also use a combination of these medications to manage pain. […] Many patients go home after hip fracture surgery, but some will need short-term care in a rehabilitation facility. Usually, these patients are elderly or have no caregivers at home.

• #2 Hip Fracture Education – Baptist Health

  https://www.baptisthealth.com/care-services/services/ortho-sports-medicine/patient-resources/patient-support-and-education/hip-fracture-education

  Complete the exercise program as taught by the therapy staff multiple times per day. […] Your surgeon will discuss when you will be able to drive again. […] Your surgeon will give specific instructions on when and how to change the dressing. […] Check dressing/incision every day and notify surgeon immediately if any of the following signs or symptoms are noted: Increase in redness around the incision. […] Do not wait until your next follow-up appointment. Call your surgeon if any of the following symptoms occur: Pain not controlled with medication.

• #2 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Therefore, delirium prevention efforts become extremely important after hip fracture. […] Thus, it appears that careful attention to medical and geriatric issues with an interdisciplinary team is an effective strategy in preventing delirium in this population. […] Anemia, typically defined as a hemoglobin level 10g/dl, is present in approximately half of hip fracture patients at hospital admission, and 90% postoperatively. […] Given the potential for adverse events with transfusion, a conservative strategy of transfusing only when symptomatic, or in high-risk patients with hemoglobin 8g/dl is recommended. […] Rehabilitation is a cornerstone in efforts to reduce rates of ambulatory and functional impairment, but limited evidence is available to inform on the optimal venue for such therapy.

• #2 Fracture Nursing Care Plans: 11 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/fracture-nursing-care-plans/

  As a nurse, it is important to provide education and support to the patient and their family, addressing their questions and concerns, and ensuring they have the knowledge and skills needed for a successful recovery. […] Constipation can occur in patients with fractures due to decreased physical activity, pain medication use, and immobility. […] As a nurse, it is important to monitor the patients bowel movements and provide education on diet and fluid intake, as well as assist with implementing measures such as stool softeners or enemas to prevent constipation and maintain regular bowel function. […] Medications used in patients with fractures are initially focused on pain management to facilitate comfort; but also some medications used play a significant role in preventing complications such as infection, muscle spasms, and blood clot formation, and promoting bone healing, ultimately enhancing the patients recovery.

• #2 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  Maintaining mobility, energy and participation in self-care during an older persons hospital stay can maintain their independence, reduce the likelihood of falls and fall-related injuries and minimise loss of confidence due to fear of falling. […] Discharge planning should be a coordinated effort between the patient, the patients family, the multidisciplinary team and staff in the destination setting, if the patient is to be discharged to another care facility. […] Effective evidence-based nursing care is one of the crucial factors that impact on patient outcomes following hip fracture. […] Nurses caring for patients in the perioperative period need to understand different types of hip fracture and their management so that they can deliver evidence-based acute and perioperative care to patients with hip fracture based on each persons specific needs.

• #2 Hip fracture – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/hip-fracture-discharge

  You may start showering again when your surgeon says it is OK. After you shower, gently pat the incision area dry with a clean towel. Do not rub it dry. […] Change your dressing (bandage) over your incision every day if your surgeon says it is OK. Gently wash the wound with soap and water and pat it dry. […] To prevent another fracture, do everything you can to make your bones strong. […] Keep wearing the compression stockings you used in the hospital until your surgeon says you can stop. Wearing them for at least 2 or 3 weeks may help reduce clots after surgery. […] If you have pain, take the pain medicines you were prescribed. Getting up and moving around can also help reduce your pain. […] Contact your surgeon if you have: Shortness of breath or chest pain when you breathe, Frequent urination or burning when you urinate, Redness or increasing pain around your incision, Drainage from your incision, Swelling in one of your legs (it will be red and warmer than the other leg), Pain in your calf, Fever higher than 101°F (38.3°C), Pain that is not controlled by your pain medicines, Nosebleeds or blood in your urine or stools, if you are taking blood thinners.

• #2 Discharge Instructions for Hip Fracture Surgery | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hip-fracture-surgery

  Use a cane, crutches, a walker, or handrails until your balance, flexibility, and strength improve. […] Follow your healthcare provider’s orders about how much weight to place on the affected leg. […] Do all exercises as advised. […] Make a follow-up appointment as advised by your healthcare provider. […] Call your healthcare provider right away if you have any of the following: Hip pain gets worse. […] Swelling or redness at the incision site gets worse.

• #2 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #2 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Early rehabilitation and weight-bearing initiated within 24 hours postoperatively are associated with improved mobility outcomes. […] Patients with acute hip fractures should receive postoperative oral bisphosphonates, and those with decreased BMD should receive longer-term treatment to prevent secondary fractures with agents, including bisphosphonates, parathyroid analogs (teriparatide or abaloparatide [Tymlos]), and RANKL inhibitors (denosumab [Prolia] or romosozumab [Evenity]). […] Physical activity is effective for primary and secondary prevention of hip fractures, and the U.S. Preventive Services Task Force recommends exercise to prevent falls in adults older than 65 years.

• #2 Hip fracture 2: nursing care from admission to secondary prevention | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/hip-fracture-2-nursing-care-from-admission-to-secondary-prevention-21-01-2019/

  Skilled nursing assessment and management and multidisciplinary working are key to recovery. […] The secondary prevention of fragility fractures is an integral part of care. […] Nursing staff have a key role in assessing and managing patients, and in reducing risks associated with immobility and malnutrition.

• #2 Hip fracture care | Leading Better Value Care | Agency for Clinical Innovation

  https://aci.health.nsw.gov.au/statewide-programs/lbvc/hip-fracture-care

  A hip fracture is a break occurring at the top of the thigh bone (femur), near the pelvis. It is a significant injury in an older person and is associated with significant morbidity, loss of function and mortality. Sub-optimal management can result in avoidable complications, prolonged hospitalisation and poorer patient outcomes. […] The aims of the initiatives are to: reduce unwarranted clinical variation, improve patient assessment, management and experience, ensure effective and efficient care. […] Read about the four clinical priority areas for hip fracture care: timely assessment and treatment of pain, surgery within 36-hours of arriving at hospital (if appropriate), coordinated orthopaedic and geriatric services, patients getting back on their feet within a day if possible. […] Explore options for different organisational models to tailor clinical services for your local requirements: structured orthogeriatric service, coordinated care applying orthogeriatric principles. […] Consumer fact sheet: Hip fracture care, Clinician fact sheet: Hip fracture care, Orthogeriatric hip fracture care.

• #2 Hip fracture 1: identifying and managing risk factors | Nursing Times

  https://www.nursingtimes.net/musculoskeletal-and-orthopaedics/hip-fracture-1-identifying-and-managing-risk-factors-10-12-2018/

  It is essential that nurses identify risk factors and actively seek to reduce the potential for harm. […] Nurses in all settings are ideally placed to identify people at risk of hip fracture and facilitate collaboration with multidisciplinary and specialist teams. […] They contribute greatly to risk assessment, education and health promotion, and some initiate and monitor medical and lifestyle interventions.

• #2 Perioperative Management of Hip Fracture Patients Undergoing Total Hip Replacement | IntechOpen

  https://www.intechopen.com/chapters/61675

  Patients with hip fractures have high morbidity and mortality, which has not changed significantly since last two decades. […] NICE guidelines recommend total hip replacement (THR) rather than hemiarthroplasty in patients with a displaced intracapsular hip fracture in selected patients. […] Outcomes after THR for displaced fractures of hip are similar to those after THR for elective surgery. Careful selection of patients is essential to achieve this success. […] Risk of significant morbidity and mortality in these patients can be reduced by early surgical fixation of the fracture and early, effective rehabilitation. […] Multidisciplinary care improves the quality and efficiency of hip fracture care. […] Good nursing care with regular input from orthogeriatricians, adequate analgesia, hydration and nutrition are all important for good postoperative outcomes.

• #3 Hip Fracture: Diagnosis, Treatment, and Secondary Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p945.html

  Following a hip fracture, patients should usually be treated with a bisphosphonate, regardless of their bone mineral density, unless contraindicated. […] Patients should receive post-fracture rehabilitation to help restore functional capability. […] Early surgery (within 24 to 48 hours) is prudent. This allows earlier mobilization and rehabilitation, which speeds functional recovery and decreases the risk of pneumonia, skin breakdown, deep venous thrombosis, and urinary tract infections. […] Patients should receive prophylactic antibiotics within one to two hours before surgery, particularly against Staphylococcus aureus, the major pathogen of concern. […] Patients should receive thromboembolic prophylaxis, preferably with low-molecular-weight heparin. […] Most patients benefit from a fall-prevention assessment, which includes removing home environmental hazards, reviewing medications, and assessing muscle strength, balance, and gait. […] All patients require rehabilitation therapy after hospital discharge, but the best strategies to improve mobility are not fully known. […] Long-term care is essential to return the patient to the most functional state as soon as possible, ideally to prefracture level of activity.

• #3 Hip Fracture – Fractures – Fundamentals of Nursing – Picmonic for Nursing RN

  https://www.picmonic.com/pathways/nursing/courses/standard/fundamentals-of-nursing-273/fractures-1447/hip-fracture_2116

  Hip Fractured Picmonic Fractures that occur in the upper third of the femur bone are called hip fractures. This type of fracture is common in older adults and is usually caused by falling. Assessment of the patient with a broken hip will reveal shortening and external rotation of the affected leg, muscle spasms, and pain. A patient may be placed in Bucks traction for 24 to 48 hours before undergoing surgery, in an effort to stabilize the patient and reduce muscle spasms. Patients should be monitored closely for avascular necrosis, or death of bone tissue, resulting from insufficient blood supply to the affected area. […] Assessment of the patient with a broken hip will reveal external rotation of the leg. When the leg is externally rotated, the foot will be in a horizontal position with the toes pointing outward.

• #3 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  Patients with hip fracture are susceptible to foreseeable and potentially avoidable complications. An interprofessional team approach to care that uses evidence-based strategies for prevention, early detection, and proactive care to avoid complications is key to optimal patient outcomes. […] The majority of these patients will enter the hospital via the ED. Consideration must be given to providing an environment that is sensitive to the care needs of this vulnerable population. […] Nurses can play an important role in advocating for timely access to surgery. […] A. Determine the patients preadmission cognitive status and cognitive presentation on admission using a standardized tool and information from family. […] A. Assess for malnutrition on admission using a standardized screening tool.

• #3 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Aggressive pain control with higher doses of opiates and/or regional blocks are associated with lower delirium rates. […] Overall, evidence suggests that that aggressive pain control is an important goal in managing hip fracture patients. Frequent pain assessment, especially in patients with dementia, and regular use of parenteral or oral opiates is generally required. […] Therefore, close attention to prevention of this potentially life-threatening complication is required. […] Practice guidelines released in 2012 from the American College of Chest Physicians recommend a minimum of 10-14 days of prophylaxis with either low molecular weight heparin, fondaparinux, low-dose unfractionated heparin, adjusted dose warfarin, aspirin or an intermittent pneumatic compression device. […] Delirium occurs in a quarter of patients without baseline dementia, and over half of dementia patients who experience a hip fracture.

• #3 Home | UCSF Hip Fracture Protocol

  https://hipfracture.ucsf.edu/home

  All patients with hip fractures should receive timely, effective, multi-modal analgesia. As part of this the Departments of Anesthesia and Perioperative Care, Emergency Medicine, Orthopedic Surgery recommend all patients receive an ultrasound-guided fascia iliaca block (FIB) as soon as appropriate and possible as this has been shown to decrease pain, need for opioids, and assist in timely transfer to OR. […] DVT prophylaxis: start POD #1. […] Start Calcium Carbonate 1250mg daily on discharge (alternatively can order extra strength Tums twice daily). […] If PCP not able to be contacted or to manage osteoporosis, Geriatrics or medicine consult places 'referral to orthopaedics-skeletal health’ for follow up 1-2 months after discharge.

• #3 Nursing Care Plan For Elderly Patient With Hip Fracture – Mks Nursing Healthcare

  https://mksnursinghealthcare.com/nursing-care-plan-for-elderly-patient-with-hip-fracture/

  Administer prescribed analgesics as needed. Implement non-pharmacological methods for pain relief, such as ice packs or positioning. […] Reposition the patient every 2 hours to prevent pressure ulcers. Use pressure-relieving devices, like special mattresses or cushions. […] Evaluate pain levels before and after interventions to determine effectiveness. […] Record all assessments, interventions, and evaluations. Document pain levels, response to pain management strategies, wound status, mobility progress, and bowel movements.

• #3 Care plan help for hip fracture – Nursing Student Assistance

  https://allnurses.com/care-plan-help-hip-fracture-t518289/

  Nursing dx 1: Right Hip Fracture r/t musculoskeletal impairment […] Interventions: q2h turn, monitor for skin breakdown, not sure about others […] Nursing dx 2: I am having a hard time coming up for this one related to the pneumonia. […] Nursing Interventions: Monitor rate, depth, and ease of respirations, Monitor for signs of hyperventilation, Monitor O2 sats […] Nursing dx 3: Chronic confusion r/t alzheimer’s disease. […] Care plans are all about the assessment…of the patient. Let the patient/patient assessment drive your diagnosis. […] The medical diagnosis is the disease itself. It is what the patient has not necessarily what the patient needs. […] Care plan reality: The foundation of any care plan is the signs, symptoms or responses that patient is having to what is happening to them.

• #3 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Hip fractures are common causes of disability, with mortality rates reaching 30% at one year. […] Operative management within 24 to 48 hours of the fracture optimizes outcomes. […] Pre- and postoperative antistaphylococcal antibiotics are given to prevent joint infection. […] Early postoperative mobilization, followed by rehabilitation, improves outcomes. […] Subsequent care focuses on prevention, with increased physical activity, home safety assessments, and minimizing polypharmacy. […] An interdisciplinary care team, including orthopedic surgeons, hospitalists, dietitians, geriatric services, and physical and occupational therapists, reduce postoperative complications and in-hospital mortality and improve functional status. […] Hip fractureassociated delirium is a common complication in hospitalized patients, both pre- and postoperatively.

• #3 Hip Fracture Education – Baptist Health

  https://www.baptisthealth.com/care-services/services/ortho-sports-medicine/patient-resources/patient-support-and-education/hip-fracture-education

  A gait belt will be applied any time that you are out of bed. […] It is a device that is used to help prevent falls and provide support for patients with mobility issues. […] Do not get up without the assistance of staff and a gait belt in place. […] Patients usually require a hospital stay of three to five days, but this will be based on your medical needs. […] Your surgeon will help determine when you can resume normal activities such as work, driving and exercising. […] The surgeon will provide you with verbal and written instructions on self-care during recovery. […] Pain medication is prescribed for home use. […] Early mobility combined with an anticoagulant (blood thinner) helps prevent blood clots after surgery. […] You will be at greater risk of constipation after surgery due to being less mobile and on pain medication.

• #3 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures

  Most patients are able to get of bed and start physical therapy the day after surgery. It is important to begin moving as soon as possible. This helps prevent medical complications, such as blood clots, pneumonia, and bed sores. For older patients, it also helps prevent disorientation and deconditioning. […] During recovery, you will work with physical and occupational therapists. They will give you exercises and tell you how much weight you can put on your leg. They will also show you how to manage the activities of daily living, such as bathing and dressing. […] Your doctor and nurses will work with you to help reduce your pain. Typically, you will be given medicine through an IV in the first few hours after surgery. Then you will be switched to oral pain medicine. This may take the form of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or over-the-counter pain medication such as acetaminophen. Your doctor may also use a combination of these medications to manage pain. […] Many patients go home after hip fracture surgery, but some will need short-term care in a rehabilitation facility. Usually, these patients are elderly or have no caregivers at home.

• #3 Hip fracture – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/hip-fracture-discharge

  You may start showering again when your surgeon says it is OK. After you shower, gently pat the incision area dry with a clean towel. Do not rub it dry. […] Change your dressing (bandage) over your incision every day if your surgeon says it is OK. Gently wash the wound with soap and water and pat it dry. […] To prevent another fracture, do everything you can to make your bones strong. […] Keep wearing the compression stockings you used in the hospital until your surgeon says you can stop. Wearing them for at least 2 or 3 weeks may help reduce clots after surgery. […] If you have pain, take the pain medicines you were prescribed. Getting up and moving around can also help reduce your pain. […] Contact your surgeon if you have: Shortness of breath or chest pain when you breathe, Frequent urination or burning when you urinate, Redness or increasing pain around your incision, Drainage from your incision, Swelling in one of your legs (it will be red and warmer than the other leg), Pain in your calf, Fever higher than 101°F (38.3°C), Pain that is not controlled by your pain medicines, Nosebleeds or blood in your urine or stools, if you are taking blood thinners.

• #3 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #3 Fracture Nursing Care Plans: 11 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/fracture-nursing-care-plans/

  As a nurse, it is important to provide education and support to the patient and their family, addressing their questions and concerns, and ensuring they have the knowledge and skills needed for a successful recovery. […] Constipation can occur in patients with fractures due to decreased physical activity, pain medication use, and immobility. […] As a nurse, it is important to monitor the patients bowel movements and provide education on diet and fluid intake, as well as assist with implementing measures such as stool softeners or enemas to prevent constipation and maintain regular bowel function. […] Medications used in patients with fractures are initially focused on pain management to facilitate comfort; but also some medications used play a significant role in preventing complications such as infection, muscle spasms, and blood clot formation, and promoting bone healing, ultimately enhancing the patients recovery.

• #3 Discharge Instructions for Hip Fracture Surgery | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hip-fracture-surgery

  Use a cane, crutches, a walker, or handrails until your balance, flexibility, and strength improve. […] Follow your healthcare provider’s orders about how much weight to place on the affected leg. […] Do all exercises as advised. […] Make a follow-up appointment as advised by your healthcare provider. […] Call your healthcare provider right away if you have any of the following: Hip pain gets worse. […] Swelling or redness at the incision site gets worse.

• #3 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #3 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  The specialists of the Memorial Hermann Hip Fracture Program are dedicated to providing the highest quality care to you and your family member(s). […] Our goal is to minimize the time you are in pain, prevent complications commonly caused by lack of mobility, including bed sores, blood clots and pneumonia, and to ensure that you remain an active participant in your care experience. […] An important goal of our specialized hip fracture program is an early effective pain control and medical/ surgical intervention, which leads to the best possible result for you. […] After a hip fracture, patients typically arrive at Memorial Hermann through the Emergency Department or are admitted directly from a nursing or assisted living facility. […] As quickly as possible, an anesthesiologist will evaluate you and take steps in order to manage the pain you will be experiencing, and a hospitalist will continue your treatment by making sure you are medically stable and prepared for surgery.

• #3 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  Maintaining mobility, energy and participation in self-care during an older persons hospital stay can maintain their independence, reduce the likelihood of falls and fall-related injuries and minimise loss of confidence due to fear of falling. […] Discharge planning should be a coordinated effort between the patient, the patients family, the multidisciplinary team and staff in the destination setting, if the patient is to be discharged to another care facility. […] Effective evidence-based nursing care is one of the crucial factors that impact on patient outcomes following hip fracture. […] Nurses caring for patients in the perioperative period need to understand different types of hip fracture and their management so that they can deliver evidence-based acute and perioperative care to patients with hip fracture based on each persons specific needs.

• #4 Hip Fracture Nursing Care Plan

  https://rnspeak.com/hip-fracture-nursing-care-plan/

  Hip fractures are among the most frequent fractures presented to the emergency department and orthopedic trauma teams. […] An estimated 340,000 hip fractures occur each year. […] The majority of hip fractures result from falls in the older adult population. […] Nursing interventions for a client diagnosed with hip fracture include the prevention of falls, strengthening of the bone quality, and lifestyle modifications. […] Effective pain management is critical since the pain has been found to increase morbidity from hip fractures. […] Severe pain significantly increases delirium in older adult clients and is associated with longer time to mobilization, increased hospital stay, and decreased functional outcomes. […] The blood supply to the femoral head plays an important role when deciding the management of hip fractures. […] The overreaching health care challenge after hip fracture and surgery is to maximize mobility and encourage older adults to return to their usual activities of daily living and engage in physical activity.

• #4 Turning a pt with hip fracture/broken hip – General Nursing Support

  https://allnurses.com/turning-pt-hip-fracture-broken-t399807/

  Never turn a hip fracture patient onto the affected side without specific orders. You can „tip” them a bit, but not onto the hip if it has not been 'fixed’. […] You need to have sufficient pillows-minimum of 2- between the thighs/knees to avoid making the alignment worse and increasing pain/spasms. Do not let the leg (whichever one is affected) adduct or rotate. The pillows will support the affected hip while turning them onto the left hip to check their back. Never turn a hip patient by yourself…always have another person help, who knows how to turn a hip patient. […] It is extremely important these patients are turned or they will literally lay in one spot from admission until surgery. […] Most of these pts will (hopefully) be in Buck’s traction. Please, I beg each of the members reading this post, steer clear of the traction. Just one accidental bump into the weights will send a pt over the edge in pain!

• #4 Nursing Care Plan For Elderly Patient With Hip Fracture – Mks Nursing Healthcare

  https://mksnursinghealthcare.com/nursing-care-plan-for-elderly-patient-with-hip-fracture/

  Administer prescribed analgesics as needed. Implement non-pharmacological methods for pain relief, such as ice packs or positioning. […] Reposition the patient every 2 hours to prevent pressure ulcers. Use pressure-relieving devices, like special mattresses or cushions. […] Evaluate pain levels before and after interventions to determine effectiveness. […] Record all assessments, interventions, and evaluations. Document pain levels, response to pain management strategies, wound status, mobility progress, and bowel movements.

• #4 Hip fracture – discharge Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/discharge-instructions/hip-fracture-discharge

  You may start showering again when your surgeon says it is OK. After you shower, gently pat the incision area dry with a clean towel. Do not rub it dry. […] Change your dressing (bandage) over your incision every day if your surgeon says it is OK. Gently wash the wound with soap and water and pat it dry. […] To prevent another fracture, do everything you can to make your bones strong. […] Keep wearing the compression stockings you used in the hospital until your surgeon says you can stop. Wearing them for at least 2 or 3 weeks may help reduce clots after surgery. […] If you have pain, take the pain medicines you were prescribed. Getting up and moving around can also help reduce your pain. […] Contact your surgeon if you have: Shortness of breath or chest pain when you breathe, Frequent urination or burning when you urinate, Redness or increasing pain around your incision, Drainage from your incision, Swelling in one of your legs (it will be red and warmer than the other leg), Pain in your calf, Fever higher than 101°F (38.3°C), Pain that is not controlled by your pain medicines, Nosebleeds or blood in your urine or stools, if you are taking blood thinners.

• #4 Hip Fractures – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hip-fractures

  Most patients are able to get of bed and start physical therapy the day after surgery. It is important to begin moving as soon as possible. This helps prevent medical complications, such as blood clots, pneumonia, and bed sores. For older patients, it also helps prevent disorientation and deconditioning. […] During recovery, you will work with physical and occupational therapists. They will give you exercises and tell you how much weight you can put on your leg. They will also show you how to manage the activities of daily living, such as bathing and dressing. […] Your doctor and nurses will work with you to help reduce your pain. Typically, you will be given medicine through an IV in the first few hours after surgery. Then you will be switched to oral pain medicine. This may take the form of opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or over-the-counter pain medication such as acetaminophen. Your doctor may also use a combination of these medications to manage pain. […] Many patients go home after hip fracture surgery, but some will need short-term care in a rehabilitation facility. Usually, these patients are elderly or have no caregivers at home.

• #4 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Hip fractures are best treated with a team approach. You and your family are an important part of your care team, especially when it comes to decisions before, during and after your treatment. […] After your surgery, you’ll be moved to the Post Anesthesia Care Unit (PACU), also called the recovery room. You’ll stay there until the anesthesia wears off and you are stable. This usually takes a few hours. You will then be moved back to your hospital room. […] It is important that you don’t stay in bed too long after your surgery. Physical therapy will begin the day of your surgery or the next morning, depending on the time of day your surgery is scheduled. Your goal is to increase your activity a little each day to build your strength and continue your recovery outside of the hospital. […] Even with medication, some pain is normal after surgery. You will receive pain medication by taking pills or through an IV. Ice packs can also be used to help lessen pain and swelling. The goal is to reduce your pain enough so that you can do the physical therapy exercises that will help you heal and regain as much independence as possible.

• #4 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Therefore, delirium prevention efforts become extremely important after hip fracture. […] Thus, it appears that careful attention to medical and geriatric issues with an interdisciplinary team is an effective strategy in preventing delirium in this population. […] Anemia, typically defined as a hemoglobin level 10g/dl, is present in approximately half of hip fracture patients at hospital admission, and 90% postoperatively. […] Given the potential for adverse events with transfusion, a conservative strategy of transfusing only when symptomatic, or in high-risk patients with hemoglobin 8g/dl is recommended. […] Rehabilitation is a cornerstone in efforts to reduce rates of ambulatory and functional impairment, but limited evidence is available to inform on the optimal venue for such therapy.

• #4 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Early rehabilitation and weight-bearing initiated within 24 hours postoperatively are associated with improved mobility outcomes. […] Patients with acute hip fractures should receive postoperative oral bisphosphonates, and those with decreased BMD should receive longer-term treatment to prevent secondary fractures with agents, including bisphosphonates, parathyroid analogs (teriparatide or abaloparatide [Tymlos]), and RANKL inhibitors (denosumab [Prolia] or romosozumab [Evenity]). […] Physical activity is effective for primary and secondary prevention of hip fractures, and the U.S. Preventive Services Task Force recommends exercise to prevent falls in adults older than 65 years.

• #4 Fracture Nursing Care Plans: 11 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/fracture-nursing-care-plans/

  As a nurse, it is important to provide education and support to the patient and their family, addressing their questions and concerns, and ensuring they have the knowledge and skills needed for a successful recovery. […] Constipation can occur in patients with fractures due to decreased physical activity, pain medication use, and immobility. […] As a nurse, it is important to monitor the patients bowel movements and provide education on diet and fluid intake, as well as assist with implementing measures such as stool softeners or enemas to prevent constipation and maintain regular bowel function. […] Medications used in patients with fractures are initially focused on pain management to facilitate comfort; but also some medications used play a significant role in preventing complications such as infection, muscle spasms, and blood clot formation, and promoting bone healing, ultimately enhancing the patients recovery.

• #4 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  You can leave the hospital when your doctor determines that you are medically stable. The next step of your treatment plan depends on how well you can safely move around. Your safety and the prevention of falls is a priority often overlooked and underestimated by patients and families. […] Recovering from a hip fracture is not easy; it takes a lot of hard work and can take from three months to a year to heal. With proper care and rehabilitation, some people may return to pre-injury levels of activity and independence. […] Your safety and the prevention of recurrent falls is our priority in deciding upon the right location for recovery after the hospital. […] Follow your doctor’s orders. Depending on your surgery, your doctor will tell you what percent of weight you can put on your hip. If you were sent home with a walker, cane, crutches or wheelchair, be sure to use them.

• #4 Hip Fracture Care | Essentia Health

  https://www.essentiahealth.org/services/orthopedics-sports-medicine/hip-fracture

  Expect Essentia Health to provide post-surgery hospital care that helps prevent common complications associated with hip fractures, so you can heal sooner. […] Count on Essentia Health to support your long-term recovery following a hip fracture. Your hospital care team will help you decide the best place to go after leaving the hospital. […] A few weeks after you leave the hospital, visit your primary care provider to discuss your risk for osteoporosis thin, weak bones and the best ways to prevent future falls and fractures.

• #4 Recovery at Home After a Hip Fracture | Best Care

  https://bestcaremn.com/blog/healing-after-the-fall-recovery-at-home-after-a-hip-fracture/

  If possible, the person should not sit for more than 45 minutes at a time; otherwise, your family member’s physical therapist will prescribe exercises to help maintain healthy blood circulation. […] When recovering from a hip fracture, it is important for the person to eat foods that are rich in protein, calcium, and vitamin D. […] If possible, install grab rails in the shower and obtain a skid proof bench for the shower. […] Many families find that the services of a personal care assistant are invaluable. They assist people who are recovering from a hip fracturing with moving around their home, attending to their personal hygiene, taking care of housekeeping and meal preparation, and transportation to appointments.

• #4 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #4 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  The experienced team at Memorial Hermann will focus specifically on you and your family. […] Nursing Team (Registered Nurse, Licensed Vocational Nurse, Patient Care Assistants) – Before, during and after your surgery, you can expect to meet different nurses who perform many different jobs. […] Your physical therapist is trained to help you gain strength and motion after your surgery and will help ensure that you do your exercises correctly. […] Your occupational therapist is trained to help you learn to safely and effectively perform activities of daily living, such as bathing and dressing. […] Managing your pain safely and effectively is important to us. […] If you are having pain, please report it to your caregiver immediately. […] Complications can occur after a hip fracture and, generally, are related to immobilization.

• #4 Hip Fracture Nursing Care Plan Guide – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/hip-fracture-nursing-care-plan-guide/

  Nurses teach patients to move safely after a hip fracture. This includes showing how to use walking aids correctly. They start patients slowly back on their feet, and they guide them in exercises to get strong again. […] Many different experts are needed to care for hip fractures properly. Working together, they make sure the patient gets well. This team might include doctors, physical therapists, and diet experts. […] Nurses focus on a few main things to help those with hip fractures. They work on pain, making sure the patient is safe, getting them moving again, and avoiding problems like infections. But they also give a lot of emotional help and teach them about their care. […] It’s key to stop possible hip fractures, especially for older folks. Being active in preventing falls means less future injuries. This guide helps combine tactics for fall protection and keeping bones strong.

• #5 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #5 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Hip fractures are best treated with a team approach. You and your family are an important part of your care team, especially when it comes to decisions before, during and after your treatment. […] After your surgery, you’ll be moved to the Post Anesthesia Care Unit (PACU), also called the recovery room. You’ll stay there until the anesthesia wears off and you are stable. This usually takes a few hours. You will then be moved back to your hospital room. […] It is important that you don’t stay in bed too long after your surgery. Physical therapy will begin the day of your surgery or the next morning, depending on the time of day your surgery is scheduled. Your goal is to increase your activity a little each day to build your strength and continue your recovery outside of the hospital. […] Even with medication, some pain is normal after surgery. You will receive pain medication by taking pills or through an IV. Ice packs can also be used to help lessen pain and swelling. The goal is to reduce your pain enough so that you can do the physical therapy exercises that will help you heal and regain as much independence as possible.

• #5 Discharge Instructions for Hip Fracture Surgery | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/discharge-instructions-hip-fracture-surgery

  Use a cane, crutches, a walker, or handrails until your balance, flexibility, and strength improve. […] Follow your healthcare provider’s orders about how much weight to place on the affected leg. […] Do all exercises as advised. […] Make a follow-up appointment as advised by your healthcare provider. […] Call your healthcare provider right away if you have any of the following: Hip pain gets worse. […] Swelling or redness at the incision site gets worse.

• #5 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  The experienced team at Memorial Hermann will focus specifically on you and your family. […] Nursing Team (Registered Nurse, Licensed Vocational Nurse, Patient Care Assistants) – Before, during and after your surgery, you can expect to meet different nurses who perform many different jobs. […] Your physical therapist is trained to help you gain strength and motion after your surgery and will help ensure that you do your exercises correctly. […] Your occupational therapist is trained to help you learn to safely and effectively perform activities of daily living, such as bathing and dressing. […] Managing your pain safely and effectively is important to us. […] If you are having pain, please report it to your caregiver immediately. […] Complications can occur after a hip fracture and, generally, are related to immobilization.

• #5 Hip Fracture: Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/hip-fracture-nursing-diagnosis-care-plan/

  Nursing Diagnosis: Risk for Infection […] The surgical site must be kept clean and dry at all times. Educate the patient and family members on how to provide appropriate wound care at discharge. […] Infection prevention includes strict hand hygiene. Always wash hands when visibly soiled and use alcohol-based hand rubs before touching the patient. […] Antibiotic therapy is often provided for patients following surgery to prevent infection and promote wound healing.

• #5 Fracture Nursing Care Plans: 11 Nursing Diagnosis – Nurseslabs

  https://nurseslabs.com/fracture-nursing-care-plans/

  Promote adequate nutrition for bone healing and support […] Educate the patient and the family on fracture care, rehabilitation exercises, and preventive measures […] Address psychological and emotional needs, such as anxiety, fear, and frustration, related to the fracture and its impact on daily life. […] Nursing diagnoses provide a standardized method for recognizing, prioritizing, and addressing specific client needs and responses in relation to fractures, including both actual and high-risk problems. […] Goals and expected outcomes may include: Client will maintain the stability and alignment of fractures. […] Client will evidence callus formation or initial union at the fracture site, where applicable. […] Client will verbalize relief from pain and discomfort. […] Client will demonstrate an ability to engage in activities with minimal discomfort.

• #5 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Continue your physical therapy. Do any exercises that your doctor or physical therapist recommend and continue to go to physical therapy as prescribed. Staying active will help strengthen your bones. Exercise is the most important thing you can do to ensure the best recovery possible. […] From discharge through recovery and beyond, there are things you can do to ensure you stay in your best health and prevent injuries in the future.

• #5 Postoperative management of hip fractures: interventions associated with improved outcomes

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3727802/

  Although evidence supporting a specific type or venue of rehabilitation after hip fracture is lacking, a sensible approach in my opinion is to provide the most intensive regimen tolerated by the patient, addressing both physical and instrumental tasks with an interdisciplinary team. […] Secondary fracture prevention, in particular bisphosphonate therapy, reduces subsequent fracture rates and mortality and should be considered in all hip fracture patients. […] Because of the complexity of care after hip fracture, models of care including clinical pathways, geriatrics consultation or specialized wards may facilitate high quality, interdisciplinary care and therefore improve outcomes.

• #5 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #5 Home | UCSF Hip Fracture Protocol

  https://hipfracture.ucsf.edu/home

  All patients with hip fractures should receive timely, effective, multi-modal analgesia. As part of this the Departments of Anesthesia and Perioperative Care, Emergency Medicine, Orthopedic Surgery recommend all patients receive an ultrasound-guided fascia iliaca block (FIB) as soon as appropriate and possible as this has been shown to decrease pain, need for opioids, and assist in timely transfer to OR. […] DVT prophylaxis: start POD #1. […] Start Calcium Carbonate 1250mg daily on discharge (alternatively can order extra strength Tums twice daily). […] If PCP not able to be contacted or to manage osteoporosis, Geriatrics or medicine consult places 'referral to orthopaedics-skeletal health’ for follow up 1-2 months after discharge.

• #5 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  The aim of this chapter is to outline the care of older people with fragility fractures of the hip, the most significant injury requiring orthogeriatric care. […] The principal skills and knowledge needed to look after patients with hip fractures well apply across the management of all older people with fractures and includes all the fundamental aspects of nursing care for the adult as well as specialised interventions for older people. […] Surgery is the preferred treatment for hip fracture because it provides stable fixation, facilitates full weight bearing and decreases the risk of complications. […] The primary goal of nursing care for the older adult with fragility hip fracture is to maximise mobility and preserve optimal function; psychosocial factors, however, must be incorporated into a holistic approach to care so that patients can be motivated to rehabilitate.

• #6 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #6 Hip fracture – discharge : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000168.htm

  Hip fracture surgery is done to repair a break in the upper part of your thigh bone. This article tells you how to take care of yourself when you go home from the hospital. […] You should have received physical therapy while you were in the hospital or at a rehabilitation center before going home from the hospital. […] Most of the problems that develop after hip fracture surgery can be prevented by getting out of bed and walking as soon as possible. For this reason, it is very important to stay active and follow the instructions your surgeon gave you. […] Do the exercises your physical therapist taught you. Ask your surgeon how much weight you can put on your leg. You should be using crutches and a walker when you leave the hospital. Your surgeon and physical therapist will help you decide when you no longer need crutches, a cane, or a walker.

• #6 Orthogeriatric Nursing in the Emergency and Perioperative In-Patient Setting – Fragility Fracture Nursing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK543818/

  Maintaining mobility, energy and participation in self-care during an older persons hospital stay can maintain their independence, reduce the likelihood of falls and fall-related injuries and minimise loss of confidence due to fear of falling. […] Discharge planning should be a coordinated effort between the patient, the patients family, the multidisciplinary team and staff in the destination setting, if the patient is to be discharged to another care facility. […] Effective evidence-based nursing care is one of the crucial factors that impact on patient outcomes following hip fracture. […] Nurses caring for patients in the perioperative period need to understand different types of hip fracture and their management so that they can deliver evidence-based acute and perioperative care to patients with hip fracture based on each persons specific needs.

• #6 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #6 Hip Fracture: Diagnosis, Treatment, and Secondary Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0615/p945.html

  Following a hip fracture, patients should usually be treated with a bisphosphonate, regardless of their bone mineral density, unless contraindicated. […] Patients should receive post-fracture rehabilitation to help restore functional capability. […] Early surgery (within 24 to 48 hours) is prudent. This allows earlier mobilization and rehabilitation, which speeds functional recovery and decreases the risk of pneumonia, skin breakdown, deep venous thrombosis, and urinary tract infections. […] Patients should receive prophylactic antibiotics within one to two hours before surgery, particularly against Staphylococcus aureus, the major pathogen of concern. […] Patients should receive thromboembolic prophylaxis, preferably with low-molecular-weight heparin. […] Most patients benefit from a fall-prevention assessment, which includes removing home environmental hazards, reviewing medications, and assessing muscle strength, balance, and gait. […] All patients require rehabilitation therapy after hospital discharge, but the best strategies to improve mobility are not fully known. […] Long-term care is essential to return the patient to the most functional state as soon as possible, ideally to prefracture level of activity.

• #6 Hip Fractures: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/hip-fractures.html

  Early rehabilitation and weight-bearing initiated within 24 hours postoperatively are associated with improved mobility outcomes. […] Patients with acute hip fractures should receive postoperative oral bisphosphonates, and those with decreased BMD should receive longer-term treatment to prevent secondary fractures with agents, including bisphosphonates, parathyroid analogs (teriparatide or abaloparatide [Tymlos]), and RANKL inhibitors (denosumab [Prolia] or romosozumab [Evenity]). […] Physical activity is effective for primary and secondary prevention of hip fractures, and the U.S. Preventive Services Task Force recommends exercise to prevent falls in adults older than 65 years.

• #6 Hip Fracture | Memorial Hermann

  https://memorialhermann.org/services/conditions/hip-pain-and-injuries/hip-fracture

  Getting out of bed and moving can reduce the risk of developing these complications. […] The best treatment is to prevent bed sores in the first place. […] The best way to prevent pressure ulcers is to get you out of bed and moving when possible. […] There are many ways to reduce the risk of DVT, but the most effective is getting you moving as soon as possible. […] Your dietitian will assist you in planning menu choices to ensure you have the proper diet. […] In order for you to return to your highest level of function as quickly as possible, it is imperative that you have adequate pain control to be able to move around throughout the day. […] Your physical therapist will begin with personalized exercises with you to not only help move the hip, but also to increase your strength and range of motion in your hip. […] After this type of injury you will need an assistive device to help you walk, such as a rolling walker, a 3-in-1 commode, or tub transfer bench.

• #6 Nursing Care Plan For Elderly Patient With Hip Fracture – Mks Nursing Healthcare

  https://mksnursinghealthcare.com/nursing-care-plan-for-elderly-patient-with-hip-fracture/

  Administer prescribed analgesics as needed. Implement non-pharmacological methods for pain relief, such as ice packs or positioning. […] Reposition the patient every 2 hours to prevent pressure ulcers. Use pressure-relieving devices, like special mattresses or cushions. […] Evaluate pain levels before and after interventions to determine effectiveness. […] Record all assessments, interventions, and evaluations. Document pain levels, response to pain management strategies, wound status, mobility progress, and bowel movements.

• #7 Nursing Care Plan For Impaired Mobility Related To Hip Fracture – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-impaired-mobility-related-to-hip-fracture/

  Impaired mobility due to a hip fracture is a profound health concern that significantly affects the physical, emotional, and functional well-being of individuals. […] A hip fracture often necessitates immediate medical attention and comprehensive nursing care to mitigate complications, promote recovery, and restore the patients quality of life. […] Consequently, nursing care plays a pivotal role in facilitating the journey toward recovery and restoration of mobility. […] Nurses are central figures in the care of patients with hip fractures. […] This nursing care plan serves as a testament to our unwavering commitment to delivering compassionate, patient-centered care to individuals facing impaired mobility due to hip fractures. […] Our mission is to provide comprehensive support, alleviate suffering, and empower patients as they embark on their path to recovery and mobility restoration.

• #7 Hip Fracture Education for Patients & Families > Beacon Health System

  https://www.beaconhealthsystem.org/hip-care/hip-fracture-education/

  Hip fractures are best treated with a team approach. You and your family are an important part of your care team, especially when it comes to decisions before, during and after your treatment. […] After your surgery, you’ll be moved to the Post Anesthesia Care Unit (PACU), also called the recovery room. You’ll stay there until the anesthesia wears off and you are stable. This usually takes a few hours. You will then be moved back to your hospital room. […] It is important that you don’t stay in bed too long after your surgery. Physical therapy will begin the day of your surgery or the next morning, depending on the time of day your surgery is scheduled. Your goal is to increase your activity a little each day to build your strength and continue your recovery outside of the hospital. […] Even with medication, some pain is normal after surgery. You will receive pain medication by taking pills or through an IV. Ice packs can also be used to help lessen pain and swelling. The goal is to reduce your pain enough so that you can do the physical therapy exercises that will help you heal and regain as much independence as possible.

• #7 Recovery at Home After a Hip Fracture | Best Care

  https://bestcaremn.com/blog/healing-after-the-fall-recovery-at-home-after-a-hip-fracture/

  If possible, the person should not sit for more than 45 minutes at a time; otherwise, your family member’s physical therapist will prescribe exercises to help maintain healthy blood circulation. […] When recovering from a hip fracture, it is important for the person to eat foods that are rich in protein, calcium, and vitamin D. […] If possible, install grab rails in the shower and obtain a skid proof bench for the shower. […] Many families find that the services of a personal care assistant are invaluable. They assist people who are recovering from a hip fracturing with moving around their home, attending to their personal hygiene, taking care of housekeeping and meal preparation, and transportation to appointments.

• #7 Recovery at Home After a Hip Fracture | Best Care

  https://bestcaremn.com/blog/healing-after-the-fall-recovery-at-home-after-a-hip-fracture/

  Additionally, many older adults recovering from a hip fracture find the services of a home health personal care assistant to be invaluable. […] The two main challenges a caregiver faces when they are tending to the needs of a family member who is recovering from a hip fracture are ensuring they have enough exercise and that the older person is receiving enough nutrition in their diet. […] Once your loved one has returned home, you’ll need to show them the changes you have made in the home. […] Additionally, it is very important for the person to take pain medication as directed because if their pain flares up, the person is going to have difficulty doing their exercises and moving around their home. […] One of the dangers people face after a hip fracture is the formation of blood clots.

• #7 Prevention of Hip Fracture | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/hip-fracture/treatments/prevention.html

  Preventing a hip fracture is more desirable than treating one. Preventive measures include taking in enough calcium every day. For women past menopause and not taking estrogen, the National Institutes of Health (NIH) recommends 1,500 milligrams (mg) daily. For those taking estrogen, the recommendation is 1,000 mg. Middle-aged men should take 1,000 mg daily. […] Women at menopause should consider having a bone density test. A bone density test is used to measure the bone mineral content and thickness of the bone. This measurement can indicate decreased bone mass, a condition in which bones are more brittle and more prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk. […] Another way to help prevent hip fracture is to engage in regular weight-bearing exercise such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote strength and balance. Other preventive measures may include: Taking medications as prescribed by your physician to prevent bone loss, Eating a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli, Stopping smoking, Avoiding excessive alcohol use, Keeping objects off the stairs and floors, such as electrical cords, to prevent falls, Using slip-resistant rugs next to the bathtub and installing grab bars in the tub, Positioning night lights from the bedroom to the bathroom, Using rug pads or non-skid backing to keep rugs in place, Not using unsteady furniture or step ladders to stand on, Visiting an ophthalmologist every year to have vision checked annually and vision loss treated.

• #7 Managing Patients With Hip Fracture | HIGN

  https://hign.org/consultgeri/resources/protocols/managing-patients-hip-fracture

  A. Assume the patient has moderate to severe pain. Recognize that unmanaged pain increases complications, impedes recovery, and increases mortality. […] A. Assess prehospital bowel habits and management. […] A. Avoid indwelling catheters. Use an indwelling catheter only if evidence-based criteria are met, for example, Centers for Disease Control and Prevention (CDC) criteria. […] A. Conduct a head-to-toe, pressure point assessment on admission and then each shift. […] A. Recognize that hip fracture patients are at high risk for VTE. […] A. Monitor fluid balance after surgery. […] The nurse is responsible for ensuring timely and consistent postoperative mobility. […] A. Both verbal and written instructions on preparing to go to the next level of care should begin early in the hospital stay. […] A. Ensure consultation with fracture liaison service before discharge.

• #8 Hip Fracture Education – Baptist Health

  https://www.baptisthealth.com/care-services/services/ortho-sports-medicine/patient-resources/patient-support-and-education/hip-fracture-education

  Complete the exercise program as taught by the therapy staff multiple times per day. […] Your surgeon will discuss when you will be able to drive again. […] Your surgeon will give specific instructions on when and how to change the dressing. […] Check dressing/incision every day and notify surgeon immediately if any of the following signs or symptoms are noted: Increase in redness around the incision. […] Do not wait until your next follow-up appointment. Call your surgeon if any of the following symptoms occur: Pain not controlled with medication.

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