Pub Date : 2025-06-14DOI: 10.1016/j.ijotn.2025.101209
Rebecca Willis , Rania Edris , Sally Akehurst , Francesco V. Ferraro
Pre-operative rehabilitation is an effective means of reducing Length of Stay (LoS), but little evidence is available on its influence on Total Hip Replacement (THR) patients. Hence, a review of UK-based experimental studies to evaluate the effect of physical therapy on LoS was performed. Subsequently, a narrative synthesis was employed to develop a three-round Delphi study targeting UK clinicians. The review and Delphi results showed that patients had higher satisfaction with education clinics, but nurse-led assessment and physiotherapist education were not superior to standard pre-operative practices. The Delphi highlighted the challenges and benefits of (p)rehabilitation and provided suggestions for THR best practices. In conclusion, the study shows that there is a lack of evidence on the effectiveness of (p)rehabilitation on LoS; further research is recommended into education, (p)rehabilitation and patient self-efficacy interventions to enhance THR patients' pathways.
{"title":"Do pre- and post- rehabilitation influence hospital length of stay and patient recovery following total hip replacement in the UK? A systematic scoping review and Delphi study","authors":"Rebecca Willis , Rania Edris , Sally Akehurst , Francesco V. Ferraro","doi":"10.1016/j.ijotn.2025.101209","DOIUrl":"10.1016/j.ijotn.2025.101209","url":null,"abstract":"<div><div>Pre-operative rehabilitation is an effective means of reducing Length of Stay (LoS), but little evidence is available on its influence on Total Hip Replacement (THR) patients. Hence, a review of UK-based experimental studies to evaluate the effect of physical therapy on LoS was performed. Subsequently, a narrative synthesis was employed to develop a three-round Delphi study targeting UK clinicians. The review and Delphi results showed that patients had higher satisfaction with education clinics, but nurse-led assessment and physiotherapist education were not superior to standard pre-operative practices. The Delphi highlighted the challenges and benefits of (p)rehabilitation and provided suggestions for THR best practices. In conclusion, the study shows that there is a lack of evidence on the effectiveness of (p)rehabilitation on LoS; further research is recommended into education, (p)rehabilitation and patient self-efficacy interventions to enhance THR patients' pathways.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101209"},"PeriodicalIF":1.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Enhanced Recovery after Surgery (ERAS) program has been a turning point for healthcare professionals and patient's surgical units. To optimize patient relief, a new multimodal analgesia (MMA) protocol was deployed. Implementing this protocol required several professionals, with their roles and interactions emerging as key factors to explore.
Objective
The aim of this qualitative study is to describe the interprofessional collaboration (IC) process during the MMA protocol implementation with surgical healthcare professionals.
Method
A secondary analysis of data from a descriptive qualitative study was conducted. A total of 71 participants, including registered nurses, assistant nurses, managers/educators, residents, surgeons, and pharmacists, took part in semi-structured interviews. Emerging ideas were synthesized using thematic analysis (Braun and Clark, 2006) and then categorized based on constructs defined by the Sunnybrook framework (McLaney et al., 2022).
Results
Several subthemes emerged from secondary analysis: professional roles, interprofessional communication, beliefs, interprofessional trust, interprofessional influence, and nurse autonomy. The protocol implementation fostered role clarification, more efficient and relevant communication, highlighted interprofessional values and ethics, and shared decision-making.
Benefits
Three emerging findings from this analysis: the importance for professionals of having a shared vision, the need for effective and relevant communication, and the importance of fully occupying professional roles.
Conclusion
Successful MMA protocol implementation relying on IC could optimize pain management for surgical patients in ERAS trajectories. The ERAS program optimized post-surgical pain management, with successful MMA implementation relying on IC. This analysis highlights the importance of involving all relevant professionals in complex interventions like post-op pain relief to maximize outcomes.
手术后增强恢复（ERAS）计划已经成为医疗保健专业人员和患者外科单位的一个转折点。为了优化患者的缓解，一种新的多模式镇痛（MMA）方案被部署。实施这一协议需要几位专业人士，他们的作用和相互作用成为探索的关键因素。目的本定性研究的目的是描述外科医疗保健专业人员在MMA协议实施过程中的跨专业协作（IC）过程。方法对描述性定性研究资料进行二次分析。共有71名参与者参加了半结构化访谈，包括注册护士、助理护士、管理人员/教育者、住院医生、外科医生和药剂师。利用主题分析（Braun and Clark, 2006）对新兴观点进行综合，然后根据Sunnybrook框架定义的结构进行分类（McLaney et al., 2022）。结果二级分析产生了几个子主题：专业角色、专业间沟通、信念、专业间信任、专业间影响和护士自主性。协议的实施促进了角色澄清，更有效和相关的沟通，突出了专业间的价值观和道德，以及共同决策。从这个分析中可以得出三个新发现：专业人员拥有共同愿景的重要性，有效和相关沟通的必要性，以及充分发挥专业角色的重要性。结论基于IC的MMA方案的成功实施可以优化ERAS手术患者的疼痛管理。ERAS项目优化了术后疼痛管理，成功的MMA实施依赖于IC。该分析强调了让所有相关专业人员参与复杂干预（如术后疼痛缓解）以最大化结果的重要性。
{"title":"Interprofessional collaboration in surgical setting during the implementation of a multimodal analgesia protocol: A qualitative study","authors":"Emilie Bourdeau , Emilie Paul-Savoie , Johanne Lapré , Sylvie Lafrenaye , Patricia Bourgault , Emilie Gosselin","doi":"10.1016/j.ijotn.2025.101207","DOIUrl":"10.1016/j.ijotn.2025.101207","url":null,"abstract":"<div><h3>Introduction</h3><div>The Enhanced Recovery after Surgery (ERAS) program has been a turning point for healthcare professionals and patient's surgical units. To optimize patient relief, a new multimodal analgesia (MMA) protocol was deployed. Implementing this protocol required several professionals, with their roles and interactions emerging as key factors to explore.</div></div><div><h3>Objective</h3><div>The aim of this qualitative study is to describe the interprofessional collaboration (IC) process during the MMA protocol implementation with surgical healthcare professionals.</div></div><div><h3>Method</h3><div>A secondary analysis of data from a descriptive qualitative study was conducted. A total of 71 participants, including registered nurses, assistant nurses, managers/educators, residents, surgeons, and pharmacists, took part in semi-structured interviews. Emerging ideas were synthesized using thematic analysis (Braun and Clark, 2006) and then categorized based on constructs defined by the Sunnybrook framework (McLaney et al., 2022).</div></div><div><h3>Results</h3><div>Several subthemes emerged from secondary analysis: professional roles, interprofessional communication, beliefs, interprofessional trust, interprofessional influence, and nurse autonomy. The protocol implementation fostered role clarification, more efficient and relevant communication, highlighted interprofessional values and ethics, and shared decision-making.</div></div><div><h3>Benefits</h3><div>Three emerging findings from this analysis: the importance for professionals of having a shared vision, the need for effective and relevant communication, and the importance of fully occupying professional roles.</div></div><div><h3>Conclusion</h3><div>Successful MMA protocol implementation relying on IC could optimize pain management for surgical patients in ERAS trajectories. The ERAS program optimized post-surgical pain management, with successful MMA implementation relying on IC. This analysis highlights the importance of involving all relevant professionals in complex interventions like post-op pain relief to maximize outcomes.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101207"},"PeriodicalIF":1.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This nursing-focused study compared the effectiveness of continuous cryotherapy (CC) versus traditional ice packs (IP) in managing postoperative pain, knee swelling, range of motion (ROM), and patient satisfaction following anterior cruciate ligament reconstruction (ACLR).
Methods
A randomized controlled trial was conducted with 72 post-ACLR patients, equally assigned to receive either CC or IP. Cold therapy was administered by trained orthopedic nurses three times daily, each session lasting 30 min, over three consecutive postoperative days. Pain was assessed using the Visual Analog Scale (VAS). Knee swelling was measured by mid-patella circumference using a tape measure, and range of motion (ROM) was measured using a goniometer. All assessments were performed before and after each morning cold therapy session on postoperative days 1, 2, and 3 by one nurse assessor, before the administration of analgesics or physiotherapy, ensuring standardized, nursing-led evaluations.
Results
Participants were predominantly male, with sports injuries being the primary cause of ACL rupture. Baseline characteristics were comparable between groups. By day 3, the CC group demonstrated significantly lower VAS scores (1.03 ± 0.61) than the IP group (2.69 ± 0.89; p < 0.001), less swelling (0.93 ± 0.72 cm vs. 1.37 ± 0.78 cm; p = 0.015), and greater ROM (62.19 ± 6.57° vs. 48.08 ± 7.15°; p < 0.001).
Conclusions
When integrated into nursing practice, CC was more effective than traditional IP in reducing postoperative pain, swelling, and enhancing knee mobility following ACLR. These findings underscore the crucial role of nurses in delivering evidence-based interventions that promote recovery.
{"title":"Enhancing patient outcomes after anterior cruciate ligament reconstruction with continuous cryotherapy: A Nursing-Focused Randomized Control Trial","authors":"Linh Thuy Khanh Tran , Quyen Thi Kim Nguyen , Huy Quoc Hoang , Bach Nguyen , Vinh Quang Pham","doi":"10.1016/j.ijotn.2025.101206","DOIUrl":"10.1016/j.ijotn.2025.101206","url":null,"abstract":"<div><h3>Objective</h3><div>This nursing-focused study compared the effectiveness of continuous cryotherapy (CC) versus traditional ice packs (IP) in managing postoperative pain, knee swelling, range of motion (ROM), and patient satisfaction following anterior cruciate ligament reconstruction (ACLR).</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted with 72 post-ACLR patients, equally assigned to receive either CC or IP. Cold therapy was administered by trained orthopedic nurses three times daily, each session lasting 30 min, over three consecutive postoperative days. Pain was assessed using the Visual Analog Scale (VAS). Knee swelling was measured by mid-patella circumference using a tape measure, and range of motion (ROM) was measured using a goniometer. All assessments were performed before and after each morning cold therapy session on postoperative days 1, 2, and 3 by one nurse assessor, before the administration of analgesics or physiotherapy, ensuring standardized, nursing-led evaluations.</div></div><div><h3>Results</h3><div>Participants were predominantly male, with sports injuries being the primary cause of ACL rupture. Baseline characteristics were comparable between groups. By day 3, the CC group demonstrated significantly lower VAS scores (1.03 ± 0.61) than the IP group (2.69 ± 0.89; p < 0.001), less swelling (0.93 ± 0.72 cm vs. 1.37 ± 0.78 cm; p = 0.015), and greater ROM (62.19 ± 6.57° vs. 48.08 ± 7.15°; p < 0.001).</div></div><div><h3>Conclusions</h3><div>When integrated into nursing practice, CC was more effective than traditional IP in reducing postoperative pain, swelling, and enhancing knee mobility following ACLR. These findings underscore the crucial role of nurses in delivering evidence-based interventions that promote recovery.</div><div>Clinicaltrials.gov idNCT06629285.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101206"},"PeriodicalIF":1.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-09DOI: 10.1016/j.ijotn.2025.101197
Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros
{"title":"LITERATURE REVIEWS – Advancing orthopedic and trauma care through high-quality and evidence-based nursing: Impact on patient outcomes and professional practices","authors":"Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros","doi":"10.1016/j.ijotn.2025.101197","DOIUrl":"10.1016/j.ijotn.2025.101197","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101197"},"PeriodicalIF":1.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the development of rapid rehabilitation surgery, the hospitalization time for patients undergoing total hip replacement has been shortened, resulting in a reduction in their direct medical care. Postoperatively, they need long-term rehabilitation exercises to restore joint function, which poses additional challenges for health professionals.
Objective
This study aims to construct a rehabilitation management plan for the entire nursing path of hip replacement patients using the continuous care model, solve the problem of interrupted rehabilitation, and thereby improve the rehabilitation effect of patients.
Method
40 patients from September 2023 to February 2024 were selected as the control group and received routine care. From March to August 2024, 40 patients were selected as the experimental group and received the intervention plan. The differences in rehabilitation exercise compliance, rehabilitation self-efficacy, pain condition, postoperative complications, and patient satisfaction between the two groups were compared.
Result
The compliance rate of rehabilitation exercises and self-efficacy in rehabilitation were significantly higher in the experimental group than in the control group. The joint stiffness, joint dislocation, deep vein thrombosis, and pain scores of the experimental group were lower than those of the control group (P < 0.05), while there was no significant difference in joint infection.
Conclusion
By implementing the rehabilitation management plan based on the continuous care model, it can promote the rehabilitation exercise effect of patients, alleviate their pain, reduce postoperative complications, and improve patient satisfaction.
{"title":"The application of continuous care model in rehabilitation management for total hip arthroplasty patients","authors":"Liqun Dai, Ruiyan Tong, Jingjing Cai, Chenxin Deng, Yanqin Chen","doi":"10.1016/j.ijotn.2025.101205","DOIUrl":"10.1016/j.ijotn.2025.101205","url":null,"abstract":"<div><div>With the development of rapid rehabilitation surgery, the hospitalization time for patients undergoing total hip replacement has been shortened, resulting in a reduction in their direct medical care. Postoperatively, they need long-term rehabilitation exercises to restore joint function, which poses additional challenges for health professionals.</div></div><div><h3>Objective</h3><div>This study aims to construct a rehabilitation management plan for the entire nursing path of hip replacement patients using the continuous care model, solve the problem of interrupted rehabilitation, and thereby improve the rehabilitation effect of patients.</div></div><div><h3>Method</h3><div>40 patients from September 2023 to February 2024 were selected as the control group and received routine care. From March to August 2024, 40 patients were selected as the experimental group and received the intervention plan. The differences in rehabilitation exercise compliance, rehabilitation self-efficacy, pain condition, postoperative complications, and patient satisfaction between the two groups were compared.</div></div><div><h3>Result</h3><div>The compliance rate of rehabilitation exercises and self-efficacy in rehabilitation were significantly higher in the experimental group than in the control group. The joint stiffness, joint dislocation, deep vein thrombosis, and pain scores of the experimental group were lower than those of the control group (P < 0.05), while there was no significant difference in joint infection.</div></div><div><h3>Conclusion</h3><div>By implementing the rehabilitation management plan based on the continuous care model, it can promote the rehabilitation exercise effect of patients, alleviate their pain, reduce postoperative complications, and improve patient satisfaction.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101205"},"PeriodicalIF":1.5,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to identify predictors of postoperative delirium (POD) in older adult orthopedic ICU patients and develop a nomogram for predicting POD.
Methods
Patient data were collected from the Medical Information Mart for Intensive Care (MIMIC–IV). Independent predictors for POD were identified using least absolute shrinkage and selection operator and logistic regression. The nomogram was developed using selected predictors and assessed by the bootstrap method. Area under the receiver operating characteristic curves (AUC) and calibration curve were used to determine the discrimination performance and calibration ability. Clinical usefulness was assessed using decision curve analysis (DCA) and clinical impact curve (CIC).
Results
A total of 430 older adult orthopedic patients were screened out, with an incidence of POD of 36.2 %. Four independent predictors were identified, including Braden skin score (OR = 0.886; 95 % CI: 0.800–0.982; p = 0.021), mechanical ventilation (OR = 1.883; 95 % CI: 1.179–3.008; p = 0.008), cerebrovascular disease (OR = 2.113; 95 % CI: 1.165–3.831; p = 0.014) and acute physiology score III (APS III) (OR = 1.029; 95 % CI: 1.017–1.042; p < 0.001). The AUC of our nomogram was 0.724 (95 % CI: 0.674–0.774), and internal validation revealed an AUC of 0.713, which suggested moderate predictive performance. The DCA and CIC analysis suggested good clinical utility.
Conclusion
Braden skin score, mechanical ventilation, cerebrovascular disease and APSIII are significant predictors of POD in older adult orthopedic patients in the ICU, and the nomogram would be helpful in supporting nursing management of POD.
{"title":"Risk factors and nomogram for postoperative delirium in elderly orthopedic patients in the Intensive Care Unit: Retrospective study based on MIMIC–IV","authors":"Hao Chen, Jing Wang, Yu Zhang, Weihong Zhao, Mengnan Han, Jing Zhang, Jianli Li","doi":"10.1016/j.ijotn.2025.101196","DOIUrl":"10.1016/j.ijotn.2025.101196","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to identify predictors of postoperative delirium (POD) in older adult orthopedic ICU patients and develop a nomogram for predicting POD.</div></div><div><h3>Methods</h3><div>Patient data were collected from the Medical Information Mart for Intensive Care (MIMIC–IV). Independent predictors for POD were identified using least absolute shrinkage and selection operator and logistic regression. The nomogram was developed using selected predictors and assessed by the bootstrap method. Area under the receiver operating characteristic curves (AUC) and calibration curve were used to determine the discrimination performance and calibration ability. Clinical usefulness was assessed using decision curve analysis (DCA) and clinical impact curve (CIC).</div></div><div><h3>Results</h3><div>A total of 430 older adult orthopedic patients were screened out, with an incidence of POD of 36.2 %. Four independent predictors were identified, including Braden skin score (OR = 0.886; 95 % CI: 0.800–0.982; p = 0.021), mechanical ventilation (OR = 1.883; 95 % CI: 1.179–3.008; p = 0.008), cerebrovascular disease (OR = 2.113; 95 % CI: 1.165–3.831; p = 0.014) and acute physiology score III (APS III) (OR = 1.029; 95 % CI: 1.017–1.042; p < 0.001). The AUC of our nomogram was 0.724 (95 % CI: 0.674–0.774), and internal validation revealed an AUC of 0.713, which suggested moderate predictive performance. The DCA and CIC analysis suggested good clinical utility.</div></div><div><h3>Conclusion</h3><div>Braden skin score, mechanical ventilation, cerebrovascular disease and <span>APS</span> <span>III</span> are significant predictors of POD in older adult orthopedic patients in the ICU, and the nomogram would be helpful in supporting nursing management of POD.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101196"},"PeriodicalIF":1.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-22DOI: 10.1016/j.ijotn.2025.101193
Francesco V. Ferraro , Rania Edris , Thomas W. Wainwright
This paper explores a theoretical framework for integrating Inspiratory Muscle Training (IMT) into enhanced recovery pathways, emphasising its potential role in mitigating respiratory decline, reducing hospital stays, and improving functional mobility for selected patients. IMT has shown benefits in high-risk surgical populations, including those with chronic respiratory conditions, obesity, obstructive sleep apnea, and frailty. Standardised screening protocols involving respiratory muscle function tests are recommended to identify suitable candidates, with structured IMT programs ideally commencing 6–8 weeks before surgery. Implementing IMT within an enhanced recovery pathway may enhance the ability for early mobilisation, improve oxygenation, and support the functional recovery of patients. While IMT has demonstrated efficacy in various surgical populations, its specific benefits to orthopaedic patients require further consideration and investigation. Indeed, future research should focus on optimising IMT protocols and assessing patient outcomes in the short-term (e.g. length of stay and complications), and the medium-term (e.g. return to activities of daily living). By incorporating IMT into prehabilitation and rehabilitation protocols, we propose that healthcare systems may be able to improve surgical outcomes and patients’ well-being while reducing postoperative complications and healthcare burden for at-risk patients.
{"title":"Inspiratory muscle training: A theoretical framework for its selected application in orthopaedic enhancing recovery pathways","authors":"Francesco V. Ferraro , Rania Edris , Thomas W. Wainwright","doi":"10.1016/j.ijotn.2025.101193","DOIUrl":"10.1016/j.ijotn.2025.101193","url":null,"abstract":"<div><div>This paper explores a theoretical framework for integrating Inspiratory Muscle Training (IMT) into enhanced recovery pathways, emphasising its potential role in mitigating respiratory decline, reducing hospital stays, and improving functional mobility for selected patients. IMT has shown benefits in high-risk surgical populations, including those with chronic respiratory conditions, obesity, obstructive sleep apnea, and frailty. Standardised screening protocols involving respiratory muscle function tests are recommended to identify suitable candidates, with structured IMT programs ideally commencing 6–8 weeks before surgery. Implementing IMT within an enhanced recovery pathway may enhance the ability for early mobilisation, improve oxygenation, and support the functional recovery of patients. While IMT has demonstrated efficacy in various surgical populations, its specific benefits to orthopaedic patients require further consideration and investigation. Indeed, future research should focus on optimising IMT protocols and assessing patient outcomes in the short-term (e.g. length of stay and complications), and the medium-term (e.g. return to activities of daily living). By incorporating IMT into prehabilitation and rehabilitation protocols, we propose that healthcare systems may be able to improve surgical outcomes and patients’ well<strong>-</strong>being while reducing postoperative complications and healthcare burden for at-risk patients.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101193"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-21DOI: 10.1016/j.ijotn.2025.101195
Penelope Anderson , Huaqiong Zhou , Vicki Patton , John Taplin
Background
Pressure injuries are a worldwide concern for patients in the acute hospital setting. They are a common hospital-acquired complication and Australian national standards, state policies, and local procedures have been developed to reduce incidence. Risk assessment is purported to be the gold standard in prevention.
This study examined the association between the time of pressure injury risk assessment, the presence of a pressure injury prevention management plan, and the development of hospital-acquired pressure injury(s) in the high-risk cohort of hip fracture patients at a regional base hospital in New South Wales.
Method
A retrospective descriptive study was conducted from routinely collected data, extracted from the electronic medical record and the incident management system. Patients with hospital-acquired pressure injuries were matched to those without and comparisons were made.
Results
Four hundred and eighty patients presented with a primary diagnosis of hip fracture. Twenty-four (5 %) developed at least one pressure injury during admission. Eight (33 %) of the study group and four (16.5 %) of the comparison group had a risk assessment completed within 8 h per hospital procedure. There was no correlation between risk assessment within 8 h and development of a pressure injury. Patients who developed pressure injuries were older than those who did not (mean 86 vs 80 years, p = 0.021).
Conclusion
There was no correlation between early pressure injury risk assessment and pressure injury development for hip fracture patients. Formal risk assessment by nurses did not prevent pressure injuries in patients with high-risk presentation of hip fracture. Maximum prevention strategies should be routinely implemented by nurses.
{"title":"Evaluating pressure injury and time of risk assessment for adults with hip fractures: A retrospective analysis","authors":"Penelope Anderson , Huaqiong Zhou , Vicki Patton , John Taplin","doi":"10.1016/j.ijotn.2025.101195","DOIUrl":"10.1016/j.ijotn.2025.101195","url":null,"abstract":"<div><h3>Background</h3><div>Pressure injuries are a worldwide concern for patients in the acute hospital setting. They are a common hospital-acquired complication and Australian national standards, state policies, and local procedures have been developed to reduce incidence. Risk assessment is purported to be the gold standard in prevention.</div><div>This study examined the association between the time of pressure injury risk assessment, the presence of a pressure injury prevention management plan, and the development of hospital-acquired pressure injury(s) in the high-risk cohort of hip fracture patients at a regional base hospital in New South Wales.</div></div><div><h3>Method</h3><div>A retrospective descriptive study was conducted from routinely collected data, extracted from the electronic medical record and the incident management system. Patients with hospital-acquired pressure injuries were matched to those without and comparisons were made.</div></div><div><h3>Results</h3><div>Four hundred and eighty patients presented with a primary diagnosis of hip fracture. Twenty-four (5 %) developed at least one pressure injury during admission. Eight (33 %) of the study group and four (16.5 %) of the comparison group had a risk assessment completed within 8 h per hospital procedure. There was no correlation between risk assessment within 8 h and development of a pressure injury. Patients who developed pressure injuries were older than those who did not (mean 86 vs 80 years, p = 0.021).</div></div><div><h3>Conclusion</h3><div>There was no correlation between early pressure injury risk assessment and pressure injury development for hip fracture patients. Formal risk assessment by nurses did not prevent pressure injuries in patients with high-risk presentation of hip fracture. Maximum prevention strategies should be routinely implemented by nurses.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101195"},"PeriodicalIF":1.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-20DOI: 10.1016/j.ijotn.2025.101194
S.K. Risager , T.A. Pedersen , B. Viberg , A. Odgaard , M. Lindberg-Larsen , C. Abrahamsen
Background
Periprosthetic knee fractures (PPKF) following total knee arthroplasty (TKA) are rare, but represents a potentially devastating complication. A significant gap in understanding patient experiences related to the surgical treatment and recovery process remains.
Objective
The aim of the study was to explore patients' experiences 3–4 months after surgical treatment of a PPKF in the distal femur.
Method
This exploratory qualitative study employed semi-structured, open-ended interviews with patients who had undergone surgical treatment for PPKF in the distal femur. Patients were recruited during hospitalization or at follow-up visits, with all approached individuals consenting to participate. Interviews were conducted three to four months post-surgery and data were analyzed thematically.
Results
Nine patients were interviewed between spring 2023 and spring 2024. The analysis yielded three themes: 1) Patient expectations of the recovery process, 2) Patient concerns – and consequently a desire for follow-up and information, and 3) The impact of recovery on independence and social life. Each theme was further illuminated with subthemes.
Conclusion
This study highlights the major challenges of recovering from PPKFs in the distal femur, including physical pain, psychological stress, and social disruption. Unlike elective TKAs, the sudden nature of PPKFs leaves patients unprepared for the lengthy recovery process, which often leads to frustration and isolation. Dependence on family for daily tasks can intensify the feeling of being a burden. To enhance patients’ recovery experiences and outcomes, clear communication and realistic expectations are essential in addressing these issues.
{"title":"Patient experiences after surgically treated periprosthetic knee fracture in the distal femur – an explorative qualitative study","authors":"S.K. Risager , T.A. Pedersen , B. Viberg , A. Odgaard , M. Lindberg-Larsen , C. Abrahamsen","doi":"10.1016/j.ijotn.2025.101194","DOIUrl":"10.1016/j.ijotn.2025.101194","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic knee fractures (PPKF) following total knee arthroplasty (TKA) are rare, but represents a potentially devastating complication. A significant gap in understanding patient experiences related to the surgical treatment and recovery process remains.</div></div><div><h3>Objective</h3><div>The aim of the study was to explore patients' experiences 3–4 months after surgical treatment of a PPKF in the distal femur.</div></div><div><h3>Method</h3><div>This exploratory qualitative study employed semi-structured, open-ended interviews with patients who had undergone surgical treatment for PPKF in the distal femur. Patients were recruited during hospitalization or at follow-up visits, with all approached individuals consenting to participate. Interviews were conducted three to four months post-surgery and data were analyzed thematically.</div></div><div><h3>Results</h3><div>Nine patients were interviewed between spring 2023 and spring 2024. The analysis yielded three themes: 1) Patient expectations of the recovery process, 2) Patient concerns – and consequently a desire for follow-up and information, and 3) The impact of recovery on independence and social life. Each theme was further illuminated with subthemes.</div></div><div><h3>Conclusion</h3><div>This study highlights the major challenges of recovering from PPKFs in the distal femur, including physical pain, psychological stress, and social disruption. Unlike elective TKAs, the sudden nature of PPKFs leaves patients unprepared for the lengthy recovery process, which often leads to frustration and isolation. Dependence on family for daily tasks can intensify the feeling of being a burden. To enhance patients’ recovery experiences and outcomes, clear communication and realistic expectations are essential in addressing these issues.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"58 ","pages":"Article 101194"},"PeriodicalIF":1.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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