The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Meehan, Anita; Maher, Ann Butler; Brent, Louise; Copanitsanou, Panagiota; Cross, Jason; Kimber, Cheryl; MacDonald, Valerie; Marques, Andréa; Peng, Lingli; Queirós, Cármen; Roigk, Patrick; Sobolev, Boris; Skúladóttir, Sigrún Sunna; Hommel, Ami

doi:10.1016/j.ijotn.2018.11.001

Cited by 20 publications

(12 citation statements)

References 218 publications

(167 reference statements)

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“…Managing frailty, fragility, and multi-morbidity in older patients who at a higher risk of poor outcomes such as falls, fracture, perioperative complications, and readmission is an increasingly critical aspect of orthopaedic practice [19][20][21][26][27][28][29][30][31][32]. Yet, how frailty is understood and how the use of validated frailty screening tools could aid identification and augment integrated care in this context is markedly limited.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic surgeons’ perceptions of frailty and frailty screening

2020

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Background: Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods:We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior Consultants, and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation.Results: Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions: There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.

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Section: Discussionmentioning

confidence: 99%

Orthopaedic surgeons’ perceptions of frailty and frailty screening

2020

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“…Managing frailty, fragility, and multi-morbidity in older patients who at a higher risk of poor outcomes such as falls, fracture, perioperative complications, readmission is an increasingly critical aspect of orthopaedic practice [23][24][25][26][27][28][29]. Yet, how frailty is understood and how the use of validated frailty screening tools could aid identification and augment integrated care in this context is markedly limited.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Archibald

Lawless

Gill

et al. 2019

Preprint

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“…Managing frailty, fragility, and multi-morbidity in older patients who at a higher risk of poor outcomes such as falls, fracture, perioperative complications, and readmission is an increasingly critical aspect of orthopaedic practice [19][20][21][27][28][29][30][31][32][33]]. Yet, how frailty is understood and how the use of validated frailty screening tools could aid identification and augment integrated care in this context is markedly limited.…”

Section: Discussionmentioning

confidence: 99%

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Archibald

Lawless

Gill

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Over the past decade, there has been significant growth in the awareness and understanding of fragility among orthopaedic surgeons in the context of osteoporotic fractures and with it, improvements in the recognition and management of fragility fractures. Emerging as a major clinical and research focus in aged care is the concept of frailty and its associations with fragility, sarcopenia, falls and rehabilitation. Currently, research is lacking on how orthopaedic surgeons perceive frailty and the role of frailty screening. A baseline understanding of these perceptions is needed to inform integration of frailty identification and management for patient optimization in orthopaedic practices, as well as research and education efforts of patients and healthcare professionals in orthopaedic contexts. Methods We used an exploratory design guided by qualitative description to conduct 15 semi-structured telephone and in-person interviews across three orthopaedic surgeon subgroups (Registrars, Junior and Senior Consultants). Data collection and analysis occurred iteratively and was guided by thematic saturation. Results Orthopaedic surgeons have a disparate understanding of frailty. Between colleagues, frailty is often referred to non-specifically to suggest a general state of risk to the patient. Frailty screening is regarded positively but its specific utility in orthopaedic environments is questioned. Easy-to-administer frailty screening tools that are not exclusive assessments of functional status are viewed most satisfactorily. However these tools are rarely used. Conclusions There is little understanding among orthopaedic surgeons of frailty as a phenotype. Beliefs around modifiability of frailty were dissimilar as were the impact of related risk factors, such a cognitive status, chronic disease, social isolation, and environmental influences. This in turn may significantly impact on the occurrence and treatment outcomes of fragility fracture, a common orthopaedic problem in older populations. This study highlights need for knowledge translation efforts (e.g. education) to achieve cohesive understanding of frailty among health professionals.

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The International Collaboration of Orthopaedic Nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture

Cited by 20 publications

References 218 publications

Orthopaedic surgeons’ perceptions of frailty and frailty screening

Orthopaedic surgeons’ perceptions of frailty and frailty screening

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

Orthopaedic Surgeons Perceptions of Frailty and Frailty Screening

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