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Preoperative Care Management of Patients With Hip Fractures During the Wait Time Between Emergency Department Discharge and Operating Room Admission for Surgical Repair

Lucki, Michelle M.; Napier, Deborah E.; Wagner, Cynthia

doi: 10.1097/NOR.0b013e3182664986
Original Articles: Research

BACKGROUND: Recognizing a patient's needs during the emergency department to operating room interval is crucial to identify areas for improvement. A review of the literature provided no pertinent research regarding this phase of the preoperative experience.

PURPOSE: This descriptive study examined the preoperative care management of patients with hip fractures during the wait time between emergency department discharge and operating room admission.

METHOD: Data were collected through a systematic retrospective chart review. Demographic variables included gender, age, and comorbidities. Preoperative patient variables included type of analgesia, level of pain, antiembolism interventions, fluid intake, sensory perception/cognition, mobility, and nutritional intake. Subjects were patients cared for at 3 sites in a large multihospital system. A total of 137 charts were reviewed.

FINDINGS: Although findings were not statistically significant, opportunities to improve care were identified. More attention is needed to evaluate patients effectively for pain, particularly where there are cognitive deficits. Designing and implementing a program for increased bed mobility and protocols that closely monitor and manage fluid intake may offset postoperative complications.

Michelle M. Lucki, MSN, RN, Clinical Outcomes Manager, Orthopedics, Grant Medical Center/OhioHealth, Columbus, Ohio.

Deborah E. Napier, BSN, RN, MA, Quality Outcomes Manager, Orthopedics, Quality and Patient Safety Department, Riverside Methodist Hospital, Columbus, Ohio.

Cynthia Wagner, MS, RN, CNS, Clinical Nurse Specialist, Doctors Hospital/OhioHealth, Columbus, Ohio.

The authors have disclosed that they have no financial interests to any commercial company related to this educational activity.

© 2012 National Association of Orthopaedic Nurses