This article has been double-blind peer reviewedIn this article…
• Complex care needs of patients with a hip fractureIn this article…
• Development of a hip fracture pathway to meet these needsIn this article…
• Role of associate practitioners in managing the patient pathway
Authors Cliff Evans is consultant nurse in emergency medicine; John Ferguson is general manager for acute and continuing care; Tracey Croft is lead emergency nurse practitioner and practice development nurse; all at Medway Foundation Trust.
Abstract In 2016, Medway Maritime Hospital changed the way hip fracture patients are managed in the emergency department to improve their experience and get them into the care of the orthopaedic team more quickly. At the centre of the hospital's new hip fracture pathway were associate practitioners, trained to complement registered nurses in looking after patients - often frail, older people - arriving in hospital. One year after implementation, the results are promising: the time between initial assessment by paramedics and transfer to a specialist ward has been reduced from 379 to 81 minutes and the mortality rate has decreased from 11.2% to 5.7%. This article explains what led to the changes, how the new pathway works, the role of associate practitioners and what outcomes have been achieved so far.
Citation Evans C et al (2018) Involving associate practitioners in a hip fracture pathway. Nursing Times [online]; 114: 1, 22-25.Key points
Patients who have sustained a hip fracture, often frail older people, have to go through a complex journeyKey points
Reducing the time it takes for hip fracture patients to be seen by orthopaedic specialists improves their outcomesKey points
Involving associate practitioners in the care of hip fracture patients can improve the patient experienceKey points
With the right training and safeguards in place, they can safely care for patients in the emergency departmentKey points
Empowering nurse leaders to challenge the effectiveness of traditional care practices can benefit patients