International Journal of Orthopaedic and Trauma Nursing最新文献

{"title":"Literature reviews – External fixation pin site infections: Solutions, screws and Kwires","authors":"Sonya Clarke, Shareena Bibi Mohd Arif, Carmen Queiros","doi":"10.1016/j.ijotn.2024.101152","DOIUrl":"10.1016/j.ijotn.2024.101152","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101152"},"PeriodicalIF":1.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748523","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}

{"title":"Postoperative delirium in geriatric orthopedic and trauma patients: Care begins preoperatively!","authors":"Lynn Haslam-Larmer ,&nbsp;Shirin Vellani","doi":"10.1016/j.ijotn.2024.101143","DOIUrl":"10.1016/j.ijotn.2024.101143","url":null,"abstract":"<div><div>Delirium is a common and serious neuropsychiatric syndrome affecting older adults, particularly after surgery. It manifests in three forms: hypoactive, hyperactive, and mixed, with symptoms ranging from lethargy and inattention to agitation and confusion. Delirium is often misdiagnosed or overlooked, especially in its hypoactive form, which can delay treatment and worsen patient outcomes. Distinguishing delirium from dementia is crucial, as delirium is typically reversible with prompt intervention.</div><div>This article, presented in a case study format, explores the assessment and management of delirium in postoperative patients, highlighting the use of validated tools such as the Delirium Elderly at Risk (DEAR) and the Confusion Assessment Method (CAM). Early identification of at-risk patients and timely screening are critical for improving outcomes. Non-pharmacological interventions, including reorientation, sleep hygiene, sensory aids, early mobilization, and family involvement, play a vital role in preventing and managing delirium.</div><div>The article emphasizes the importance of nurses in detecting early signs of delirium and implementing preventative measures. A multidisciplinary approach, integrating ongoing screening, patient-centered care, and non-pharmacological strategies, is essential for reducing the incidence and severity of delirium. Early detection and appropriate management can significantly improve recovery and reduce long-term complications, promoting better outcomes in older adults undergoing surgery.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101143"},"PeriodicalIF":1.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700154","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}

{"title":"Older patients' experiences of shared decision-making when choosing treatment for their distal radius fracture; A qualitative study","authors":"Louise Marie Nøhr ,&nbsp;Ane Simony ,&nbsp;Charlotte Abrahamsen","doi":"10.1016/j.ijotn.2024.101153","DOIUrl":"10.1016/j.ijotn.2024.101153","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to understand how older patients experience shared decision-making (SDM) when making decisions about the treatment of their distal radius fracture (DRF).</div></div><div><h3>Methods</h3><div>An exploratory qualitative study was designed using individual in-person and telephone interviews. Twelve DRF patients were recruited during their first follow-up visit to a Danish outpatient clinic, with ten of them participating in interviews. Data was analysed using content analysis.</div></div><div><h3>Results</h3><div>Three themes emerged: 1) An acute situation, 2) Considerations influencing the treatment choice and 3) The treatment decision.</div></div><div><h3>Conclusion</h3><div>In conclusion, our study represents a pioneering effort in reporting the use of Shared Decision Making in fracture management. The sudden onset of DRF proved to be highly distressing for the patients. Providing SDM material to patients in the Emergency department (ED) aimed to empower them and prepare them for their subsequent outpatient clinic visit. However, its effectiveness varied. The demeanour of doctors played a crucial role in shaping patient experiences.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101153"},"PeriodicalIF":1.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142719923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term maintenance of a fragility fracture initiative","authors":"Christopher K. Sullivan ,&nbsp;Kristine Kocjan ,&nbsp;Trevor Tompane ,&nbsp;Jennifer Smith ,&nbsp;Benjamin M. Wheatley","doi":"10.1016/j.ijotn.2024.101144","DOIUrl":"10.1016/j.ijotn.2024.101144","url":null,"abstract":"<div><h3>Introduction</h3><div>Fragility fractures are common and have an increased chance of refracture and mortality. A process improvement project was initiated including standardized orders to improve treatment of osteoporosis-related fractures. The primary objective was to determine the implementation and maintenance of this process over time. Secondary objectives were to determine the refracture and mortality risk before and after implementation.</div></div><div><h3>Methods</h3><div>A retrospective cohort of fragility fractures treated during the 6 months prior and 6 months after implementation and for one year 6 years after implementation of the process. We measured the proportion of patients who received DEXA scans, osteoporosis laboratory blood tests, Vitamin D/Calcium supplementation, Primary Care follow-up, refracture, and 6-year mortality.</div></div><div><h3>Results</h3><div>There was a significant improvement in interventions obtained immediately after process improvement implementation. At 6-years the proportion of interventions obtained had declined and were not significantly different from pre-implementation except laboratory blood tests ordered which remained significantly improved. Mortality risk was significantly lower in the 6 months after process improvement implementation (24% vs 10%; p = 0.027). There was no significant difference in refracture in our cohort (18% vs 19%; p = 0.675).</div></div><div><h3>Discussion</h3><div>Our process improvement project showed significant improvement in interventions being performed and decreased mortality but were unable to sustain high levels of intervention. We suggest that high surgeon and resident turnover limited our ability to maintain the process improvement project over time. This study supports orthopedic surgeons implementing an osteoporosis treatment protocol for fragility fractures and the importance of continued re-education and re-implementation of process improvement protocols.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"56 ","pages":"Article 101144"},"PeriodicalIF":1.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688852","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}

{"title":"Corrigendum to “The effectiveness of prophylactic closed incision negative pressure wound therapy compared to conventional dressings in the prevention of periprosthetic joint infection post hip and knee revision arthroplasty surgery: A systematic review” [Int. J. Orthopaed. Trauma Nurs. 53 (2024) 101048]","authors":"Tracy Morgan ,&nbsp;Tamara Page ,&nbsp;Zaneta Smith","doi":"10.1016/j.ijotn.2024.101125","DOIUrl":"10.1016/j.ijotn.2024.101125","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101125"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146543","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}

{"title":"A qualitative study of older adults: The difficulties and needs of returning home after hip fractures","authors":"Paula Rocha ,&nbsp;Cristina Lavareda Baixinho ,&nbsp;Maria Adriana Henriques","doi":"10.1016/j.ijotn.2024.101141","DOIUrl":"10.1016/j.ijotn.2024.101141","url":null,"abstract":"<div><h3>Background</h3><div>Falls and consequent fractures are an increasing problem among older adults, with low rates of return to previous functional condition and a substantial risk of subsequent falls. This scenario points to the need for an improved response to this population's needs.</div></div><div><h3>Objective</h3><div>To define the difficulties and needs felt by older adults with hip fractures when returning home.</div></div><div><h3>Methods</h3><div>This was a descriptive and exploratory qualitative study. Semi-structured interviews were conducted with hip fracture patients who had been submitted to surgery and who were treated at a hospital in the central region of Portugal. Bardin's content analysis was used to analyze the data. Content analysis was carried out with the support of MAXQDA® Analytic pro 2022 software.</div></div><div><h3>Results</h3><div>The analysis of the results of the 15 interviews yielded three categories related to the difficulties perceived by hip fracture patients on returning home: functional limitations; pain; and emotional management. Regarding the needs felt, the following categories emerged: resources/help with activities of daily living; capacity-building for the return home; and information.</div></div><div><h3>Conclusions</h3><div>The needs and difficulties of older adults with hip fractures on returning home are multiple and variable. Knowledge of these aspects can significantly enhance the standardized actions of nurses in this area of intervention, contributing to the improvement of continuity of care and ensuring a safe transition.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101141"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548222","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}

{"title":"Enhanced recovery pathways in orthopaedic and trauma care. Special issue","authors":"Thomas Wainwright PhD (Prof, Guest Editor),&nbsp;Paul McLiesh (Guest Editor)","doi":"10.1016/j.ijotn.2024.101142","DOIUrl":"10.1016/j.ijotn.2024.101142","url":null,"abstract":"","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101142"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640065","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}

{"title":"Efficacy of vitamin C supplementation in preventing and treating complex regional pain syndrome type I (CRPS-I) in Orthopedic patients: A systematic review and meta-analysis","authors":"Malihe Ranjbar_moghaddam ,&nbsp;Ebrahim Nasiri-Formi ,&nbsp;Amirmohammad Merajikhah","doi":"10.1016/j.ijotn.2024.101140","DOIUrl":"10.1016/j.ijotn.2024.101140","url":null,"abstract":"<div><h3>Aim</h3><div>Complex regional pain syndrome type I (CRPS-I) is a specific type of persistent pain which is often caused by fracture and surgery. There is no effective curative therapy available. However some studies have indicated that Vitamin C (VC) can reduce the incidence of CRPS-I. This study's objective is to investigate the effectiveness VC in preventing and treating CRPS-I.</div></div><div><h3>Design</h3><div>An <u>Systematic review</u> and Meta-analysis was done.</div></div><div><h3>Data sources</h3><div>Primary research studies from PubMed, Scopus, Web of Science, ProQuest, Embase database, and Cochran Library, and Google Scholar were reviewed. This search was conducted until March 27, 2024. This study was conducted without any language, place, and time restrictions. Study results were meta-analyzed with using effect sizes. To evaluate heterogeneity, we employed the Cochrane Q test and the I2 index.</div></div><div><h3>Results</h3><div>In our systematic review, 3947 articles were initially identified, with 3939 excluded for not meeting inclusion criteria, resulting in 8 studies being critically evaluated using Cochran's risk of bias checklist. The meta-analysis revealed that VC supplementation have effect on reducing CRPS-I post-limb surgery but this result shows that the pooled effect size is not statistically significant. The heterogeneity of the studies was low (I² = 26.28%, p = 0.22). Publication bias was detected, indicating asymmetry in the funnel plot.</div></div><div><h3>Conclusion</h3><div>The results of our study showed the positive effect of VC supplementation in reducing the prevalence of CRPS-I after limb surgery.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101140"},"PeriodicalIF":1.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510051","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}

{"title":"Improving external fixator pin site care through user involvement: A quality improvement project","authors":"Anette Wulff Christiansen ,&nbsp;Trine Ahlman Petersen ,&nbsp;Cellina Maj Eline Hedkjær ,&nbsp;Julie Santy-Tomlinson ,&nbsp;Charlotte Myhre Jensen","doi":"10.1016/j.ijotn.2024.101139","DOIUrl":"10.1016/j.ijotn.2024.101139","url":null,"abstract":"<div><h3>Introduction</h3><div>External fixation is widely used in treating complex fractures and limb reconstruction. Pin site infections remain a significant complication, impacting on patients' physical and psychosocial wellbeing. This clinical improvement project at a University Hospital in Denmark aimed to enhance pin site care by involving patients and caregivers throughout the treatment pathway.</div></div><div><h3>Background</h3><div>At our hospital, approximately 55 trauma patients are annually treated with lower limb external fixators. Pin site care is crucial for preventing serious infections/osteomyelitis and involves collaboration between hospital and municipal caregivers. Traditional pin site care in our unit was complex and time-consuming, causing patient anxiety and frequent unplanned clinic visits.</div></div><div><h3>Methods</h3><div>Inspired by the Participatory Design research methodology, a quality improvement project was conducted in three phases: (1) identifying users’ needs, (2) developing solutions collaboratively, and (3) testing/evaluating these solutions. Iterative cycles of planning, acting, observing, and reflecting were employed, facilitating mutual learning among participants. Interviews with patients, families and healthcare professionals and field observations both at the hospital and in the municipality were conducted. Inspiration was sought from international literature.</div></div><div><h3>Results</h3><div>Phase 1 identified the need for improved education about infection recognition, a less painful and time-consuming dressing method, and an assessment tool for pin site infection. Phase 2 involved extensive user input to develop and implement a new dressing procedure using PolyMem™ along with an assessment tool. Phase 3 evaluated the new methods, revealing reduced patient pain, fewer clinic visits, and stable infection rates as well as less time-consuming pin site care.</div></div><div><h3>Conclusion</h3><div>The project successfully enhanced pin site care, involving users in developing a new care process, thus improving patient satisfaction and care efficiency.</div></div><div><h3>Implications for future practice</h3><div>Incorporating patient perspectives and collaborative methods can significantly improve clinical care pathways. Future efforts should focus on further integrating patient centered and participatory approaches in healthcare improvements.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101139"},"PeriodicalIF":1.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477223","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}

{"title":"Psychometric properties of Japanese version15D and cultural characteristics of quality of life undergoing patients with hip and knee arthroplasty","authors":"Kanako Yakushiji ,&nbsp;Satomi Tanaka ,&nbsp;Harri Sintonen ,&nbsp;Heidi Siira ,&nbsp;Yuriko Matsunaga-Myoji ,&nbsp;Yasuko Tabuchi ,&nbsp;Pirjo Kaakinen ,&nbsp;Maria Kääriäinen ,&nbsp;Kimie Fujita","doi":"10.1016/j.ijotn.2024.101138","DOIUrl":"10.1016/j.ijotn.2024.101138","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQoL) following total hip and knee arthroplasty (THA/TKA) may decline more in Asian countries due to lifestyle and housing factors compared with patients in Western countries.</div></div><div><h3>Aims</h3><div>To evaluate the psychometric properties of the Japanese version of 15D and clarify the characteristics of HRQoL in Japanese patients who underwent THA/TKA compared with Finnish patients.</div></div><div><h3>Methods</h3><div>This longitudinal study included 182 patients between 2019 and 2021. Patients' HRQoL was measured using the 15D preoperatively and 3 months postoperatively. Student's <em>t</em>-tests were used to compare lifestyles between Japan and Finland.</div></div><div><h3>Results</h3><div>The Japanese version of the 15D showed good internal consistency, reliability, construct validity, and responsiveness. Patients with many steps inside their house had worse HRQoL in the dimensions of mobility, distress, and vitality in Japan. There were significant differences in mobility, distress, vitality, and sexual activity dimensions between Japan and Finland 3 months postoperatively.</div></div><div><h3>Conclusions</h3><div>The lower HRQoL in Japan in the dimensions of mobility, distress, and vitality is likely due to Japan's traditional housing structure with many steps. Identifying differences in cultural and psychological characteristics, as well as by residential setting, will enable health care providers to help patients improve their HRQoL.</div></div>","PeriodicalId":45099,"journal":{"name":"International Journal of Orthopaedic and Trauma Nursing","volume":"55 ","pages":"Article 101138"},"PeriodicalIF":1.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394036","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}