Authors (including presenting author) :
Chan SF, Lee P, Sze S, Woo LC, Cheung SY, Chiu J, Lam CM, Yuen K
Affiliation :
Department of Medicine and Geriatrics, Shatin Hospital
Introduction :
Fragility fracture is common occurred in elder people, which results from a low-energy mechanical forces that would not ordinarily result in fracture. Current management of osteoporotic fracture may less focus on bedridden cases. In Department of Medicine and Geriatrics, 7 cases of fragility fracture occurred in 2017 and 2018 that may relate to direct bedside care. In view of the significant statistics and morbidity, preventive measures for patients with risk of fragility fracture are needed.
Objectives :
(1)To identify patients with high risk of fragility fractures through performing fracture risk assessment upon admission; (2)To prevent fragility fracture among frailty patients during their hospitalization stay.
Methodology :
Both staffs and carers are essential to involve in handling frailty patients carefully. The details are shown below: (1)Formulate specific assessment to identify fracture risk; (2)Train-the-trainer (TTT) workshop for nurses was conducted to educate the workflow and special nursing care on high risk fracture patients; (3)Nurses conduct fracture risk assessment and head-to-toe physical examination upon admission; (4)Supporting staffs were trained by trainer in ward for special care of fragility patients; (5)Nurses paired with supporting staffs in direct bedside care, like assisted bathing, diaper changing and patients transferring; (6)Special pyjamas would be provided for patients with high risk of fragility fracture to avoid twisting or overextension of contracture limbs when changing clothes; (7)Bedhead signage of fragility care would be posted at bedhead to alert staffs and carers; (8)Educate special nursing care to carers with educational pamphlet provided; (9)Specify nursing care plan as checklist to provide direction for selecting individualized nursing intervention to patients, which also help facilitating documentation and standardizing care.
Result & Outcome :
(1)One TTT education seminar was held in 9/2019 with 65 nurses attended the “Care of the Fragile Patient”. Total 84 supporting staffs were trained in ward during 9/2019-11/2019. (2)Nurse audit on fracture risk assessment and compliance on the workflow on fragility care would be conducted in 2Q 2021. (3)Total incident number of fragility injury will be compared with the last year in 3/2021. Conclusion: Fragility fracture is being prevalent in elderly group that should not be overlooked. The proposed fragility care is an evidence-based nursing intervention to prevent fragility injury during daily activities in hospitalization, including education to both staffs and carers.
