• Ingrid Egerod, Kirsten Rud, Kirsten Specht, Pia Søe Jensen, Anne Trangbaek, Ingerlise Rønfelt, Birte Kristensen, and Henrik Kehlet.
• The University Hospitals' Centre for Nursing and Care Research, Rigshospitalet, København Ø, Denmark. ie@ucsf.dk
• Dan Med Bull. 2010 Dec 1; 57 (12): A4199.

IntroductionTreatment of hip fractures has evolved since the introduction of fast-track surgical programs in the late 1990s. The aim of our study was to describe the quality of treatment and care related to fast-track hip fracture surgery in Denmark by external audit of patient records.Material And MethodsThis was a national multicenter audit of hospital charts from each hospital treating ≥ 50 hip fracture patients per year (n = 594).ResultsThe study demonstrated significant variability in treatment and care of patients with hip fractures among the regions of Denmark. Pain management, nutritional screening, ambulation characteristics, training in activities of daily living, and rehabilitation planning were consistently inadequate. Length of stay was 7-11 days.ConclusionAlthough the principles for fast-track surgery have been adapted to some extent at all departments in Denmark with an annual treatment of at least 50 patients with hip fractures, no single department has implemented the whole package. Hospital stay has been reduced since the introduction of fast-track regimes, and improvements were seen in many of the quality indicators. Implications for future practice include better adherence to clinical guidelines, a more homogeneous documentation system in nursing, promotion of evidence-based standards, and improved treatment and care of the physical and psychological consequences of hospitalization.

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