The article considers the development of orthopaedic nursing roles in the United Kingdom in the 1990s. The nurse practitioner role within pre-operative assessment clinics and other roles related to patient care after joint replacement surgery or trauma are described. Such roles developed because of changes in healthcare and legislation which allowed nurses to take on roles and responsibilities traditionally the preserve of other professions for the benefit of patient care.
In this study, we developed and evaluated a Continuity of Care Checklist (CCC) to assist nurses in comprehensively reviewing practices related to continuity of care for orthopaedic patients discharged from hospital to community. The CCC was designed to ensure nurses would attend to multiple dimensions of continuity including informational continuity, relational continuity and management continuity. To evaluate the CCC, patients discharged from an orthopaedic unit (n = 77) were interviewed about continuity of care. The CCC was then implemented and a second group of patients (n = 77) was interviewed to examine changes in care. Structured interviews were also conducted with nurses (n = 12) to learn about their experiences with the CCC. Interviews with patients revealed significant improvements in patient perceptions of information provision, involvement of informal caregivers in discharge, communication between hospital and community providers, consistency of information, and satisfaction with patient–provider relationships. Nurses who used the CCC found the tool improved standards for care and patient involvement in care. The CCC appears to be a practical tool for assisting nurses in systematically improving continuity of care among orthopaedic patients. Future directions for research and practice using the CCC are described.
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