People living in nursing care facilities who are ambulant and fracture their hips: description of usual care and an alternative rehabilitation pathway

Killington, Maggie; Davies, Owen; Crotty, Maria; Crane, Rhiannon; Pratt, Naomi; Mills, Kylie; McInnes, Arabella; Kurrle, Susan; Cameron, Ian D.

doi:10.1186/s12877-019-1321-x

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…Hip fracture rehabilitation. Two studies in Australia [106,107] (intervention given to the same residents in both studies) reported on a geriatric rehabilitation program for residents Synopsis of multidisciplinary healthcare service delivery: specialist and direct patient care. A complex guideline-based intervention reduced agitation and disruption behaviour in residents with dementia.…”

Section: Plos Onementioning

confidence: 99%

Models of provider care in long-term care: A rapid scoping review

et al. 2021

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Introduction One of the current challenges in long-term care homes (LTCH) is to identify the optimal model of care, which may include specialty physicians, nursing staff, person support workers, among others. There is currently no consensus on the complement or scope of care delivered by these providers, nor is there a repository of studies that evaluate the various models of care. We conducted a rapid scoping review to identify and map what care provider models and interventions in LTCH have been evaluated to improve quality of life, quality of care, and health outcomes of residents. Methods We conducted this review over 10-weeks of English language, peer-reviewed studies published from 2010 onward. Search strategies for databases (e.g., MEDLINE) were run on July 9, 2020. Studies that evaluated models of provider care (e.g., direct patient care), or interventions delivered to facility, staff, and residents of LTCH were included. Study selection was performed independently, in duplicate. Mapping was performed by two reviewers, and data were extracted by one reviewer, with partial verification by a second reviewer. Results A total of 7,574 citations were screened based on the title/abstract, 836 were reviewed at full text, and 366 studies were included. Studies were classified according to two main categories: healthcare service delivery (n = 92) and implementation strategies (n = 274). The condition/ focus of the intervention was used to further classify the interventions into subcategories. The complex nature of the interventions may have led to a study being classified in more than one category/subcategory. Conclusion Many healthcare service interventions have been evaluated in the literature in the last decade. Well represented interventions (e.g., dementia care, exercise/mobility, optimal/appropriate medication) may present opportunities for future systematic reviews. Areas with less research (e.g., hearing care, vision care, foot care) have the potential to have an impact on balance, falls, subsequent acute care hospitalization.

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Section: Plos Onementioning

confidence: 99%

Models of provider care in long-term care: A rapid scoping review

et al. 2021

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“…Yet, these patients are often left out from rehabilitation, because they are not recognized as good candidates [7]. Discharge coordination in association with rehabilitation and destination sites are reported barriers for a longer hospital LOS [11]; dementia adds to this process by increasing LOS and hospital charges [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…While about 50% of patients with hip fracture may potentially return to their pre-fracture functional level, patients with dementia suffer worse post-fracture functional impairment [ 8 , 9 ]. Although limited, a few research studies reported the benefit of post-hip fracture rehabilitation in dementia patients [ 7 , 10 , 11 ]. Yet, these patients are often left out from rehabilitation, because they are not recognized as good candidates [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA

et al. 2020

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Background About 50% of all hospitalized fragility fracture cases in older Americans are hip fractures. Approximately 3/4 of fracture-related costs in the USA are attributable to hip fractures, and these are mostly covered by Medicare. Hip fracture patients with dementia, including Alzheimer’s disease, have worse health outcomes including longer hospital length of stay (LOS) and charges. LOS and hospital charges for dementia patients are usually higher than for those without dementia. Research describing LOS and acute care charges for hip fractures has mostly focused on these outcomes in trauma patients without a known pre-admission diagnosis of osteoporosis (OP). Lack of documented diagnosis put patients at risk of not having an appropriate treatment plan for OP. Whether having a diagnosis of OP would have an effect on hospital outcomes in dementia patients has not been explored. We aim to investigate whether having a diagnosis of OP, dementia, or both has an effect on LOS and hospital charges. In addition, we also report prevalence of common comorbidities in the study population and their effects on hospital outcomes. Methods We conducted a cross-sectional analysis of claims data (2012–2013) for 2175 Medicare beneficiaries (≥65 years) in the USA. Results Compared to those without OP or dementia, patients with demenia only had a shorter LOS (by 5%; P = .04). Median LOS was 6 days (interquartile range [IQR]: 5–7), and the median hospital charges were $45,100 (IQR: 31,500 − 65,600). In general, White patients had a shorter LOS (by 7%), and those with CHF and ischemic heart disease (IHD) had longer LOS (by 7 and 4%, respectively). Hospital charges were 6% lower for women, and 16% lower for White patients. Conclusion This is the first study evaluating LOS in dementia in the context of hip fracture which also disagrees with previous reporting about longer LOS in dementia patients. Patients with CHF and IHD remains at high risk for longer LOS regardless of their diagnosis of dementia or OP.

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“…Falls, therefore, have a negative effect not only on patients and guardians but also socially and economically on the community [ 81 ]. Existing studies on rehabilitation treatment for fractures caused by falls [ 82 ], community preventive interventions and connections with long-term care [ 83 ], and multi-disciplinary approaches have been performed in other countries. In contrast, the number of studies on systems, such as the integrated association between related community organizations [ 84 ], is decreasing in South Korea [ 85 ].…”

Section: Discussionmentioning

confidence: 99%

Trends of Nursing Research on Accidental Falls: A Topic Modeling Analysis

Seo

Kim

2021

IJERPH

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This descriptive study analyzed 1849 international and 212 Korean studies to explore the main topics of nursing research on accidental falls. We extracted only nouns from each abstract, and four topics were identified through topic modeling, which were divided into aspects of fall prevention and its consequences. “Fall prevention program and scale” is popular among studies on the validity of fall risk assessment tools and the development of exercise and education programs. “Nursing strategy for fall prevention” is common in studies on nurse education programs and practice guidelines to improve the quality of patient safety care. “Hospitalization by fall injury” is used in studies about delayed discharge, increased costs, and deaths of subjects with fall risk factors hospitalized at medical institutions due to fall-related injuries. “Long-term care facility falls” is popular in studies about interventions to prevent fall injuries that occur in conjunction with dementia in long-term care facilities. It is necessary to establish a system and policy for fall prevention in Korean medical institutions. This study confirms the trends in domestic and international fall-related research, suggesting the need for studies to address insufficient fall-related policies and systems and translational research to be applied in clinical trials.

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People living in nursing care facilities who are ambulant and fracture their hips: description of usual care and an alternative rehabilitation pathway

Cited by 11 publications

References 22 publications

Models of provider care in long-term care: A rapid scoping review

Models of provider care in long-term care: A rapid scoping review

Shorter length of hospital stay for hip fracture in those with dementia and without a known diagnosis of osteoporosis in the USA

Trends of Nursing Research on Accidental Falls: A Topic Modeling Analysis

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