THE POTENTIAL EFFECTS OF AN ADAPTED NURSING DISCHARGE PLAN AMONG PATIENTS WITH HIP FRACTURES IN HOSPITAL MELAKA, MALAYSIA

Abstract

Background: Patients with hip fractures frequently face the problem of a longer stay in the ward after surgery and being readmitted, falls, and being unable to carry out daily activities after discharge from the hospital. A nursing discharge plan is widely recognised as one of the strategies for addressing these issues. In Malaysia, however, it is unknown for patients with hip fractures. As a result, this study was carried out to investigate the impact of nursing discharge planning on patients with hip fractures in Hospital Melaka, Malaysia. Methods: A total of 58 patients aged 50 years and above in the orthopaedic ward of Hospital Melaka were randomised using sealed envelopes to the intervention group (n = 29) and the control group (n = 29). The intervention group received an adapted nursing discharge plan with health education activities in the form of pamphlets and oral instructions within 24 hours of ward admission until discharge while the control group received routine discharge practices. Demographic data were taken from the study subjects while clinical data and length of stay in the ward were taken from the subjects’ medical records before discharge. After one month discharged, data for ward readmission rate and drop rate were taken from the subject's medical records while data for the subject's daily life activities were obtained through telephone calls using The Barthel Index survey form. Results: The results of the study showed that the intervention group had a shorter ward stay (U = 254.00, p = 0.008) and a higher level of independence than the control group (U = 205.00, p = 0.001). The control group had 100% of subjects who were not able to be independent in daily activities of life compared to 75.9% of the intervention group (p <0.05). Conclusion: A nursing discharge plan including a health education component starting from the patient's admission to the ward until before the discharge should be considered in the nursing practice. It could facilitate better discharge outcomes for patients with hip fractures.