An umbrella review of clinical practice guidelines for the management of patients with hip fractures and a synthesis of recommendations for the pre‐operative period

Filiatreault, Sarah; Hodgins, Marilyn J.; Witherspoon, Richelle

doi:10.1111/jan.13550

Cited by 7 publications

(3 citation statements)

References 25 publications

(42 reference statements)

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“…First, the multi-phased search strategy that includes searching bibliographic databases, CPG library databases, as well as the grey literature was developed with the support of a health science librarian. CPGs are typically not well indexed in bibliographic databases [ 36 , 39 , 64 ], therefore developing and conducting this extensive search strategy will mitigate this issue. Second, building on Johnston et al’s (2019) methodological guidance [ 36 ], our team has developed a manual to train and support study team members during each of the literature screening, critical appraisals, and data abstraction and synthesis stages of the research.…”

Section: Discussionmentioning

confidence: 99%

A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol

et al. 2022

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Background Up to 35% of older adults present to the emergency department (ED) with delirium or develop the condition during their ED stay. Delirium associated with an ED visit is independently linked to poorer outcomes such as loss of independence, increased length of hospital stay, and mortality. Improving the quality of delirium care for older ED patients is hindered by a lack of knowledge and standards to guide best practice. High-quality clinical practice guidelines (CPGs) have the power to translate the complexity of scientific evidence into recommendations to improve and standardize practice. This study will identify and synthesize recommendations from high-quality delirium CPGs relevant to the care of older ED patients. Methods We will conduct a multi-phase umbrella review to retrieve relevant CPGs. Quality of the CPGs and their recommendations will be critically appraised using the Appraisal of Guidelines, Research, and Evaluation (AGREE)-II; and Appraisal of Guidelines Research and Evaluation – Recommendations Excellence (AGREE-REX) instruments, respectively. We will also synthesize and conduct a narrative analysis of high-quality CPG recommendations. Discussion This review will be the first known evidence synthesis of delirium CPGs including a critical appraisal and synthesis of recommendations. Recommendations will be categorized according to target population and setting as a means to define the bredth of knowledge in this area. Future research will use consensus building methods to identify which are most relevant to older ED patients. Trial registration This study has been registered in the Open Science Framework registries: https://doi.org/10.17605/OSF.IO/TG7S6.

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Section: Discussionmentioning

confidence: 99%

A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol

et al. 2022

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“…An ultrasound-guided femoral nerve block is a valuable alternative to systemic analgesic in hip fracture patients as it provides analgesia to the fractured area, thereby facilitating reduction in systemic opioid administration [18]. Providing optimal pain control in hip fracture patients requires advanced nursing and physician care due to comorbidity [19][20][21]. Tus, optimizing acute pain assessment and management is important.…”

Section: Introductionmentioning

confidence: 99%

Development of a Workplace-Based Training Program for Nurse-Led Ultrasound-Guided Femoral Nerve Blocks: A Feasibility Study with the Patients’ Perspective in Focus

Saga,

Skovdahl,

Lindholm

et al. 2023

Nursing Forum

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Background. Task shifting is a systematic delegation of tasks in order to make more efficient use of the available human resources for health. Training programs and the quality of these are sparsely studied and specially they that include the patients’ perspectives to an even lesser degree. Aim. A single-center feasibility study with a convergent parallel mixed method approach, integrating quantitative and qualitative components, was conducted at an emergency department aimed to evaluate a training program for nurse-led ultrasound-guided femoral nerve block. Method. Registered nurses (RNs) (n = 5), supervising anesthesiologists (n = 7), and patients with hip fracture (n = 15) participated. The training consisted of a one-day program that included comprehensive theoretical and practical instruction in anatomy, hygiene, and the application of ultrasound. The one-day training program was evaluated through an objective structured clinical examination (OSCE). Following that, each registered nurse conducted three supervised procedures in the weeks that followed. These procedures were performed on patients admitted with hip fractures in the emergency department. The patients (n = 15) were interviewed regarding their experiences and perspectives of pain, safety, and information of the procedures in emergency department. Results. In questionnaire, the RNs and anesthesiologists agreed that the training procedures were beneficial for the patients due to pain relief. Pain intensity showed a mean baseline pain score of 6.0 (95% CI 4.9–7.1) decreasing to 2.5 (95% CI 1.4–3.6) at 30 minutes after needle extraction. The interviews revealed that all patients experienced pain relief after the in situ nerve block training procedures as well as they felt safe and taken care of. Conclusions. The training program for nurse-led ultrasound-guided femoral nerve blocks was considered feasible. All included RNs learned the procedure for task shifting in a satisfactory way.

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“…To ensure that patients with hip fractures receive the best possible care and to facilitate patients' discharge in a condition relative to their prefracture condition, certain care standards related to aspects of pre‐, intra‐ and postoperative management should be followed. In general, pre‐operative management includes timing of surgery, expedited patient management, identification and treatment of correctable comorbidities, pain management, preventive measures and multidisciplinary management (Filiatreault, Hodgins, & Witherspoon, ). In a review, Farrow et al () concluded that low compliance to care standards is associated with increased mortality, reduced likelihood of a short length of stay and increased odds of discharge to a high‐care setting (Farrow et al, ).…”

Section: Introductionmentioning

confidence: 99%

Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – A study protocol for outcome studies

Boman

Duvaland

Gaarde

et al. 2020

Journal of Advanced Nursing

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Aim To evaluate the implementation of advanced practice nursing in emergency care in Norway for patients with orthopaedic injuries, including hip fractures. The outcomes relate to quality of care and patient trust. Design A non‐inferiority study comparing an advanced practice nursing care model with a standard (physician‐led) care model. Methods Data will be collected from patient records and through the Patient Trust Questionnaire, completed by patients. The data will be analysed by descriptive and inferential statistics. Funding for the research was granted in 2015 and the regional ethical committee approved the current study in February 2019. Discussion In Norway and the other Nordic countries, advanced practice nursing is still in its infancy, especially in the emergency care context. This study will evaluate advanced practice nursing in this new context. Impact The study will add to knowledge on the quality of care provided for orthopaedic patients with minor orthopaedic injuries or hip fractures as delivered by advanced practice nurses and physicians, respectively. It will also evaluate how well‐advanced practice nursing is accepted by patients in this new context.

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An umbrella review of clinical practice guidelines for the management of patients with hip fractures and a synthesis of recommendations for the pre‐operative period

Cited by 7 publications

References 25 publications

A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol

A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol

Development of a Workplace-Based Training Program for Nurse-Led Ultrasound-Guided Femoral Nerve Blocks: A Feasibility Study with the Patients’ Perspective in Focus

Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – A study protocol for outcome studies

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