Great benefits can be gained for the patients through modest efforts by nurses and physicians such as nutritional intervention.

Background and Aims:We have previously shown that nutritional guidelines decreased the incidence of pressure ulcers in hip fracture patients. In the present study, we evaluate whether the nutritional biochemical markers s-Igf-1 (Insulin-like growth factor 1), stransthyretin and s-albumin are affected by patients' energy intake, and whether the markers are useful as predictors of postoperative complications.Material and Methods: Quasi-experimental design, with one intervention and one control group, as well as pre-and post-study measurements. eighty-eight hip fracture patients were included: 42 in the control group and 46 in the intervention group. the control group received regular nutritional support pre-and postoperatively, while the intervention group received nutritional support that followed new, improved clinical guidelines from admission to five days postoperatively. s-albumin, s-transthyretin, c-reactive protein (s-crp) and s-Igf-1 were analysed at admission and five days postoperatively as well as complications like pressure ulcer and infection.Results: the intervention group had a significantly higher energy intake; for example, 1636 kcal versus 852 kcal postoperative day 1. s-Igf-1 levels decreased significantly in the control group, while no decrease in the intervention group. s-albumin and s-transthyretin decreased and s-crp increased significantly in both groups, indicating that those markers were not affected short-term by a high-energy intake. there was no correlation between short-term postoperative complications and s-Igf-1, s-transthyretin or s-albumin at admission.Conclusion: the results of our study showed that s-Igf-1 can be used as a short-term nutritional biochemical marker, as it was affected by a five-day high-energy regimen. however, neither s-Igf-1, s-transthyretin or s-albumin were useful in predicting postoperative complications within five days postoperatively.

Little is known about how hip-fracture patients experience involvement in their own nursing care. Yet understanding this is essential in order to both meet patient expectations and ensure delivery of high-quality nursing care. The aim of the study was to describe how elderly hip-fracture patients experienced their involvement in the nursing care they received while in the orthopaedics ward. A descriptive design with a qualitative interview approach was used. Semi-structured interviews were conducted with16 hip-fracture patients, 14 days postoperative in 2012. Systematic Text Condensation was used to analyse the data collected. The findings reveal six themes: 1) experiencing severe pain, 2) feeling dependent on the nurses, 3) feeling they were not valued, 4) poor organisation, 5) positives and negatives of sharing a room with fellow patients, and 6) positive interactions with nurses that encouraged the patient. Hip-fracture patients reported experiencing very little involvement in their nursing care, to the extent that fundamental aspects of nursing care went unfulfilled. Patients did not feel valued by the nurses. Most patients described experiencing unbearable pain during their stay in the orthopaedics ward despite the existence of evidence-based and established guidelines for pain management. The result of this study indicates that there is much to do on a number of levels in the health care system to improve patient involvement in nursing care.