Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients
Introduction: Fragility hip fractures constitute a large proportion of orthogeriatric admissions to orthopedic wards. This study looked at reducing variation in care in fragility hip fracture patients using a novel approach with care bundles. The care bundle comprises 5 elements targeted at providin...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2017-06-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/2151458516681634 |
| _version_ | 1818455932793782272 |
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| author | Stephanie Bandara MBBS Genni Lynch RN Cameron Cooke MBBS Paul Varghese MBBS Nicola Ward MBBS |
| author_facet | Stephanie Bandara MBBS Genni Lynch RN Cameron Cooke MBBS Paul Varghese MBBS Nicola Ward MBBS |
| author_sort | Stephanie Bandara MBBS |
| collection | DOAJ |
| description | Introduction: Fragility hip fractures constitute a large proportion of orthogeriatric admissions to orthopedic wards. This study looked at reducing variation in care in fragility hip fracture patients using a novel approach with care bundles. The care bundle comprises 5 elements targeted at providing adequate analgesia, early mobilization, improving recognition of delirium, and decreasing rates of urinary infections. Methods: A total of 198 patients who sustained a fragility hip fracture during the intervention period were included in the study. The primary outcome measure was compliance in applying the bundle to the study population, and secondary outcome measures were in-hospital mortality, acute length of stay, delirium and duration of delirium, and urinary tract infections. Results: During the 12-month intervention period, compliance to the bundle of care was 47% (n = 92) based on the “all-or-none” approach. This was 28% higher than the preintervention rate. Overall, there was an increased rate of compliance across all individual elements of the bundle in the intervention group when compared to the preintervention group ( P = .01). The most significant clinical result was a 10.5% reduction in “in-hospital mortality” in the intervention group ( P < .001). Conclusion: This study demonstrated that the implementation of specific care bundle in patients with fragility hip fracture significantly reduces variation in care. |
| first_indexed | 2024-12-14T22:18:38Z |
| format | Article |
| id | doaj.art-418eb4163fd54bb09d8bd2b16e556682 |
| institution | Directory Open Access Journal |
| issn | 2151-4585 2151-4593 |
| language | English |
| last_indexed | 2024-12-14T22:18:38Z |
| publishDate | 2017-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-418eb4163fd54bb09d8bd2b16e5566822022-12-21T22:45:34ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45852151-45932017-06-01810.1177/2151458516681634Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture PatientsStephanie Bandara MBBS0Genni Lynch RN1Cameron Cooke MBBS2Paul Varghese MBBS3Nicola Ward MBBS4 Orthopaedic Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia Orthopaedic Department, Graduate Certificate in Diabetes Education, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia Orthopaedic Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia Geriatric and Rehabilitation Unit, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, Australia Orthopaedic Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba QLD 4102, AustraliaIntroduction: Fragility hip fractures constitute a large proportion of orthogeriatric admissions to orthopedic wards. This study looked at reducing variation in care in fragility hip fracture patients using a novel approach with care bundles. The care bundle comprises 5 elements targeted at providing adequate analgesia, early mobilization, improving recognition of delirium, and decreasing rates of urinary infections. Methods: A total of 198 patients who sustained a fragility hip fracture during the intervention period were included in the study. The primary outcome measure was compliance in applying the bundle to the study population, and secondary outcome measures were in-hospital mortality, acute length of stay, delirium and duration of delirium, and urinary tract infections. Results: During the 12-month intervention period, compliance to the bundle of care was 47% (n = 92) based on the “all-or-none” approach. This was 28% higher than the preintervention rate. Overall, there was an increased rate of compliance across all individual elements of the bundle in the intervention group when compared to the preintervention group ( P = .01). The most significant clinical result was a 10.5% reduction in “in-hospital mortality” in the intervention group ( P < .001). Conclusion: This study demonstrated that the implementation of specific care bundle in patients with fragility hip fracture significantly reduces variation in care.https://doi.org/10.1177/2151458516681634 |
| spellingShingle | Stephanie Bandara MBBS Genni Lynch RN Cameron Cooke MBBS Paul Varghese MBBS Nicola Ward MBBS Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients |
| title_full | Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients |
| title_fullStr | Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients |
| title_full_unstemmed | Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients |
| title_short | Using Care Bundles to Improve Surgical Outcomes and Reduce Variation in Care for Fragility Hip Fracture Patients |
| title_sort | using care bundles to improve surgical outcomes and reduce variation in care for fragility hip fracture patients |
| url | https://doi.org/10.1177/2151458516681634 |
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