Preventing hip fractures in care homes 2: role of the specialist nurse

2004 ◽  
Vol 13 (22) ◽  
pp. 1335-1341 ◽  
Author(s):  
Sue Davies ◽  
Donna Doherty ◽  
Jean Glover ◽  
Tracy Johnson
Keyword(s):  
Hip Fractures ◽  
Care Homes ◽  
Specialist Nurse

“Consideration of patients as networked units to identify opportunities and motivation to enhance capability”: A mixed methods study to explore a personalised Digital Health Hub Model of Care for hip fractures in South Australia (Preprint)

2021 ◽  
Author(s):  
Lalit Yadav ◽  
Tiffany K Gill ◽  
Anita Taylor ◽  
Jen DeYoung ◽  
Mellick J Chehade
Keyword(s):  
Hip Fractures ◽  
Digital Health ◽  
Family Members ◽  
South Australia ◽  
Aged Care ◽  
Mixed Methods Study ◽  
Residential Aged Care ◽  
Model Of Care ◽  
Factors Influencing

UNSTRUCTURED Introduction Majority of older people with hip fractures once admitted to acute hospital care are unable to return to their pre-fracture level of independence and a significant number are either newly admitted or return to residential aged care. Patient education involves family members and/or residential aged care staff as networked units, crucial for empowerment through improving health literacy. Advancement of digital technology has led to evolving solutions around optimising health care including self-management of chronic disease conditions and telerehabilitation. The aim of this study is to understand perspectives of older patients with hip fractures, their family members and residential aged carers, to inform the development of a digitally enabled model of care using a personalised digital health hub (pDHH). Methods A mixed methods study was conducted at a public tertiary care hospital in South Australia involving patients aged 50 years and above along with their family members and residential aged carers. Quantitative data, including basic demographic characteristics, access to computers and Internet were analysed using descriptive statistics. Spearman’s Rank Order Correlation was used to examine correlations between the perceived role of a pDHH in improving health and likelihood of subsequent usage. Whereas qualitative data included series of open-ended questions and findings were interpreted using constructs of capability, opportunity and motivation to help understand the factors influencing the likelihood of potential pDHH use Results Overall, 100 people were recruited in the study, representing 55 patients, 13 family members and 32 residential aged carers. The mean age of patients was 76.4 years (SD-8.4, age range 54-88) and females represented 60% of patients. Although a moderate negative correlation existed with increasing age and likelihood of pDHH usage (ρ= -0.50, p<0.001) the perceived role of the DHH in improving health had a strong positive correlation with the likelihood of pDHH usage by self (ρ=0.71, p<0.001) and by society, including friends and family members (ρ=0.75, p<0.001). Of particular note, almost all the patients (98%) believed they had a family member or friend /carer who would be able to help them to use a digital health platform. Whereas our qualitative findings suggest emphasising on complex interplay of capability, opportunity and motivation as crucial factors while designing a pDHH enabled model of care for hip fractures at a local context level. Conclusion Findings from this study contributed to understand the dynamics around capabilities, motivation and opportunities of patients, family members and formal carers as a “patient networked unit”. Future research recommendation must involve co-creation guided by iterative processes through improving understanding of factors influencing development and successful integration of complex digital healthcare interventions in real-world scenarios.

scholarly journals Is area deprivation associated with greater impacts of COVID-19 in care homes across England? A preliminary analysis of COVID-19 outbreaks and deaths

2021 ◽  
pp. jech-2020-215039 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Michelle Degli Esposti
Keyword(s):  
Negative Binomial ◽  
Care Home ◽  
Negative Binomial Regression ◽  
Population Characteristics ◽  
Care Homes ◽  
Future Research ◽  
Area Deprivation ◽  
Binomial Regression ◽  
Index Of Multiple Deprivation

IntroductionThe COVID-19 pandemic has disproportionately impacted care homes and vulnerable populations, exacerbating existing health inequalities. However, the role of area deprivation in shaping the impacts of COVID-19 in care homes is poorly understood. We examine whether area deprivation is linked to higher rates of COVID-19 outbreaks and deaths among care home residents across upper tier local authorities in England (n=149).MethodsWe constructed a novel dataset from publicly available data. Using negative binomial regression models, we analysed the associations between area deprivation (Income Deprivation Affecting Older People Index (IDAOPI) and Index of Multiple Deprivation (IMD) extent) as the exposure and COVID-19 outbreaks, COVID-19-related deaths and all-cause deaths among care home residents as three separate outcomes—adjusting for population characteristics (size, age composition, ethnicity).ResultsCOVID-19 outbreaks in care homes did not vary by area deprivation. However, COVID-19-related deaths were more common in the most deprived quartiles of IDAOPI (incidence rate ratio (IRR): 1.23, 95% CI 1.04 to 1.47) and IMD extent (IRR: 1.16, 95% CI 1.00 to 1.34), compared with the least deprived quartiles.DiscussionThese findings suggest that area deprivation is a key risk factor in COVID-19 deaths among care home residents. Future research should look to replicate these results when more complete data become available.

The role of paediatricians in specialist nurse training: a community child health example

2021 ◽  
pp. edpract-2020-320797
Author(s):  
Cliona Ni Bhrolchain
Keyword(s):  
Child Health ◽  
Training Programme ◽  
Formal Training ◽  
Nurse Training ◽  
Training Curriculum ◽  
Clinical Specialty ◽  
Specialist Nurse ◽  
Training Programmes ◽  
Nursing Roles

Specialist and advanced nursing roles have started to emerge in paediatrics and paediatricians may be asked to support nurses through their training. While there are specific training programmes for some areas of practice eg, neonatology, there are currently no programmes for others. Paediatricians may therefore find themselves being asked to train nurse specialists outside a formal training programme, or to provide the clinical specialty component linked to a generic MSc course, where the paediatrician may be required to devise a training curriculum specific to their area of practice. Using, neonatology, there are currently no programmes for others. Paediatricians may therefore find themselves being asked to train nurse specialists outside a formal training programme, or to provide the clinical specialty component linked to a generic MSc course, where the paediatrician may be required to devise a training curriculum specific to their area of practice. Using community child health as an example, this paper outlines how paediatricians might approach this, based on the experience of the author. However, the principles outlined can apply to any area of paediatrics.

Staphylococcus aureus (MSSA and MRSA) Carriage in Care Homes: identification of risk factors, including the role of dementia

2010 ◽  
Vol 61 (6) ◽  
pp. 520
Author(s):  
Gemma Lasseter ◽  
André Charlett ◽  
Deirdre Lewis ◽  
Ian Donald ◽  
Rebecca Howell-Jones ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Care Homes

The role of the specialist nurse in headache

Headache ◽  
2008 ◽  
pp. 269-274
Author(s):  
David Kernick ◽  
Peter Goadsby
Keyword(s):  
Specialist Nurse

The role of the MS specialist nurse

2007 ◽  
pp. 185-190
Author(s):  
John Zajicek ◽  
Jennifer Freeman ◽  
Bernadette Porter
Keyword(s):  
Specialist Nurse

Post procedure

2020 ◽  
pp. 315-322
Author(s):  
Andrew Mitchell ◽  
Giovanni Luigi De Maria ◽  
Adrian Banning
Keyword(s):  
Discharge Summary ◽  
Specialist Nurse ◽  
Post Procedure

This chapter covers the actions required after the patient has undergone their procedure. It begins by explaining the role of the specialist nurse team, the checks that should be performed on the patient once they have returned to the ward, and the process for becoming ambulant. The chapter then goes on to explain how to review the results and data regarding the case. Communication of both results and potential follow-up procedures is then covered. The chapter ends by addressing discharge plans and guidance is given on completing a discharge summary.

scholarly journals Medial migration in cephalomedullary nail fixation of pertrochanteric hip fractures

2019 ◽  
Vol 8 (7) ◽  
pp. 313-322 ◽  
Author(s):  
G. W. Law ◽  
Y. R. Wong ◽  
A. K-S. Yew ◽  
A. C. T. Choh ◽  
J. S. B. Koh ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Hip Fractures ◽  
Tensile Loading ◽  
Biomechanical Analysis ◽  
Cephalomedullary Nail ◽  
Compression Loading ◽  
Medial Migration ◽  
Group 3 ◽  
Group 2

Objectives The paradoxical migration of the femoral neck element (FNE) superomedially against gravity, with respect to the intramedullary component of the cephalomedullary device, is a poorly understood phenomenon increasingly seen in the management of pertrochanteric hip fractures with the intramedullary nail. The aim of this study was to investigate the role of bidirectional loading on the medial migration phenomenon, based on unique wear patterns seen on scanning electron microscopy of retrieved implants suggestive of FNE toggling. Methods A total of 18 synthetic femurs (Sawbones, Vashon Island, Washington) with comminuted pertrochanteric fractures were divided into three groups (n = 6 per group). Fracture fixation was performed using the Proximal Femoral Nail Antirotation (PFNA) implant (Synthes, Oberdorf, Switzerland; n = 6). Group 1 was subjected to unidirectional compression loading (600 N), with an elastomer (70A durometer) replacing loose fracture fragments to simulate surrounding soft-tissue tensioning. Group 2 was subjected to bidirectional loading (600 N compression loading, 120 N tensile loading), also with the elastomer replacing loose fracture fragments. Group 3 was subjected to bidirectional loading (600 N compression loading, 120 N tensile loading) without the elastomer. All constructs were tested at 2 Hz for 5000 cycles or until cut-out occurred. The medial migration distance (MMD) was recorded at the end of the testing cycles. Results The MMDs for Groups 1, 2, and 3 were 1.02 mm, 6.27 mm, and 5.44 mm respectively, with reliable reproduction of medial migration seen in all groups. Bidirectional loading groups showed significantly higher MMDs compared with the unidirectional loading group (p < 0.01). Conclusion Our results demonstrate significant contributions of bidirectional cyclic loading to the medial migration phenomenon in cephalomedullary nail fixation of pertrochanteric hip fractures. Cite this article: G. W. Law, Y. R. Wong, A. K-S. Yew, A. C. T. Choh, J. S. B. Koh, T. S. Howe. Medial migration in cephalomedullary nail fixation of pertrochanteric hip fractures: A biomechanical analysis using a novel bidirectional cyclic loading model. Bone Joint Res 2019;8:313–322. DOI: 10.1302/2046-3758.87.BJR-2018-0271.R1.

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