Orthopaedic nursing
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Orthopaedic nursing · Sep 2017
Retrospective Evaluation of the Impact of a Geriatric Trauma Institute on Fragility Hip Fracture Patient Outcomes.
Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. ⋯ This retrospective pre- and post-GTI chart review demonstrates the effectiveness of a multidisciplinary team approach in decreasing complications and LOS for fragility hip-fractured patients. A team approach to the care of these patients improves outcomes and quality of life.
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Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. ⋯ Substantial reductions in ALOS can be gained with the introduction of ERAS protocols, with high patient satisfaction and no increase in complications in a consecutive unselected group of public hospital patients. This requires a multidisciplinary approach and a strong clinical input.
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Orthopaedic nursing · Jan 2017
Implementation of a Pediatric Orthopaedic Bundle to Reduce Surgical Site Infections.
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. ⋯ Both compliance with the bundle and SSI rates must be monitored monthly. Staff and providers should be offered monthly feedback on SSI rates and care bundle compliance. If an SSI does occur, a root-cause analysis is performed with the multidisciplinary care team using a standardized review form.
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Orthopaedic nursing · Sep 2016
Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.
In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. ⋯ Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.
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Orthopaedic nursing · Jul 2016
ReviewThe Impact of Prehabilitation on Postoperative Functional Status, Healthcare Utilization, Pain, and Quality of Life: A Systematic Review.
"Preoperative rehabilitation" or prehabilitation has been increasingly studied alongside the deleterious effects of surgery and functional decline. Prehabilitation is the preoperative optimization of physical functionality to enable the individual to maintain a normal level of function during and after surgery. This systematic review evaluates the effectiveness of prehabilitation on functional status, healthcare utilization, quality of life, and pain postoperatively. ⋯ There is no evidence to show that prehabilitation has significant benefits in function, quality of life, and pain; however, it may reduce admission to rehabilitation after knee or hip arthroplasty for osteoarthritis. There is insufficient evidence to make inferences in other surgical populations, notwithstanding initial evidence does not demonstrate advantages.