Fractured neck of femur - care pathway Document Properties| Creation Date: | 03/11/2010 | | Type: | Fractured neck of femur - care pathway | | Summary: | Completion of College Of Emergency Medicine (CEM) audit on fractured neck of femur (#NOF) raised concerns as to the average time to analgesia for pts in severe pain in our Emergency Department (ED). Search of available literature concluded that pts with suspected fracture neck of femur were given a low priority and hence had to wait longer to receive analgesia. Our objective was to expedite analgesia provision to patients attending ED with suspected #NOF, to challenge current misconception of the low priority given to this vulnerable group of people, actively manage the risk of delirium and to provide seamless, patient-centred care both in ED and on transfer to ortho trauma ward.
After implementation of the pathway:
Analgesia provision for pt in severe pain reduced from a median of 62 minutes to 14 minutes.
Fluids and PRN meds are now managed prior to leaving ED.
The evidence-based pathway reduced time to analgesia provision by directing care, and further provided a concise handover sheet to support seamless care.
Pts arrived on trauma ward with hydration and PRN meds management enabling trauma staff to continue perioperative care.
Care of confused patients was highlighted by audit as area requiring further management. The Abbey pain scale is now being implemented.
Use of Entonox on arrival, before transfer to ED trolleys and prior to IV access being achieved enables CEM pain standards to be met whilst improving patients journey.
Continued liaison with our trauma coordinator, South Central Ambulance Service, Orthopaedic trauma ward, # NOF focus group will help provide a seamless service of care from pre-hospital via ED to admission to trauma ward. | | URL: | |
Contributor| Name: | Sally Cotterell & Mel Buckland | | Email: | sally.cotterell1@btinternet.com | | Speciality: | Orthopaedic nurse | | Institution: | District General Hospital | | Location: | Basingstoke & North Hants FoundationTrust |
Care Pathway| Section: | Hip fracture care | | Sub Section: | Pre-operative Assessment | | Element: | Integrated Care Pathway |
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