International partnerships: Advancing nursing care of the older adult with fragility hip fracture

Abstract

Manyolderadults fearhip fractureandtheir fear isnotunfounded; fragility hip fractures are associated with: impaired mobility, increased reliance on others, diminished health and sometimes death. Over 25% of older adults with hip fracture die within one year of fracture and of those that survive it is estimated that between 24% and 75% will not regain their pre-fracture level of independence.1 The increasing prevalence of hip fractures is a global concern. The International Osteoporosis Foundation reports that worldwide 1.6 million1 fragility hip fractures occur every year projecting that this number will climb to an annual rate of between 4.5 and 6.3 million by the year 2050.2 Costs associated with care are soaring as well and health care systems around the world are struggling to meet the demands for service in the face of increasing fiscal constraints. The case of Mrs. MaeWong, (a composite patient), illustrates the urgent need to improve care. Mrs. Mae Wong, age 87, was hurrying to the bathroom when she suddenly felt dizzy and landed on the floor. It was a full 24 h before her sister found her. EMS was summoned and she is transported to her local emergency room with pain in her right hip. An X-ray reveals a fractured hip. Historically, the focus would be on Mrs. Wong’s surgical repair, often involving prolonged preoperative fasting, spending many hours or even days, immobile, in an unfamiliar environment, awaiting access to the operating room.3,4 A urinary catheter, an IV and a dose of analgesic and perhaps an anti-emetic, ‘to help the patient settle’ were commonly part of the plan of care. Traumatic