Valerie MacDonald1, Ann Butler Maher, Hanne Mainz, Anita J Meehan, Louise Brent, Ami Hommel, Karen Hertz, Anita Taylor, Katie Jane Sheehan. 1. Valerie MacDonald, MSN, Adjunct Professor, BC Hip Fracture Redesign Initiative, UBC School of Nursing, Vancouver, British Columbia, Canada. Ann Butler Maher, MS, RN, FNP-BC (Retired), ICON Ambassador, Long Branch, NJ. Hanne Mainz, PhD, MHS, RN, Clinical Nurse Specialist, Orthopaedic Department, Arhaus University Hospital, Arhaus, Denmark. Anita J. Meehan, MSN, RN-BC, ONC, FNGNA, Clinical Nurse Specialist, Gerontology, Cleveland Clinic Akron General, Akron, OH. Louise Brent, MSc, RGN, RNP, Irish Hip Fracture Database Audit Coordinator, National Office of Clinical Audit, Royal College of Surgeons in Ireland, Dublin, Ireland. Ami Hommel, PhD, CNS, RN, Associate Professor, Malmö University, Malmö, Sweden; and Skane University Hospital, Lund, Sweden. Karen Hertz, MSc, DPSN, RGN, Advanced Nurse Practitioner, University Hospital of North Midlands, NHS Trust, Stoke on Trent Staffordshire, United Kingdom. Anita Taylor, MCISc, MNSc, GradDipOrtho, OrthoCert, RN, Orthopaedic Nurse Practitioner, Orthopaedic & Trauma Unit, Royal Adelaide Hospital, Adelaide, South Australia. Katie Jane Sheehan, PhD, PT, Academic Department of Physiotherapy, Division of Health and Social Care Research, Kings College, London, United Kingdom.
Abstract
BACKGROUND: Fragility hip fracture in older adults often has poor outcomes, but these outcomes can be improved with attention to specific quality care indicators. PURPOSE: The International Collaboration of Orthopaedic Nursing (ICON) developed an audit process to identify the extent to which internationally accepted nursing quality care indicators for older adults with fragility hip fracture are reflected in policies, protocols, and processes guiding acute care. METHODS: A data abstraction tool was created for each of 12 quality indicators. Data were collected using a mixed-methods approach with unstructured rounds. A rationale document providing evidence for the quality indicators and a user evaluation form were included with the audit tool. A purposeful sample of 35 acute care hospitals representing 7 countries was selected. RESULTS: Thirty-five hospitals (100%) completed the survey. Respondents viewed the content as relevant and applicable for the defined patient population. Although timing and frequency of implementation varied among and within countries, the identified quality indicators were reflected in the majority of policies, protocols, or processes guiding care in the hospitals surveyed. CONCLUSION: Developing and testing an audit of nurse-sensitive quality indicators for older adults with fragility hip fracture demonstrate international consensus on common core best practices to ensure optimal acute care.
BACKGROUND:Fragility hip fracture in older adults often has poor outcomes, but these outcomes can be improved with attention to specific quality care indicators. PURPOSE: The International Collaboration of Orthopaedic Nursing (ICON) developed an audit process to identify the extent to which internationally accepted nursing quality care indicators for older adults with fragility hip fracture are reflected in policies, protocols, and processes guiding acute care. METHODS: A data abstraction tool was created for each of 12 quality indicators. Data were collected using a mixed-methods approach with unstructured rounds. A rationale document providing evidence for the quality indicators and a user evaluation form were included with the audit tool. A purposeful sample of 35 acute care hospitals representing 7 countries was selected. RESULTS: Thirty-five hospitals (100%) completed the survey. Respondents viewed the content as relevant and applicable for the defined patient population. Although timing and frequency of implementation varied among and within countries, the identified quality indicators were reflected in the majority of policies, protocols, or processes guiding care in the hospitals surveyed. CONCLUSION: Developing and testing an audit of nurse-sensitive quality indicators for older adults with fragility hip fracture demonstrate international consensus on common core best practices to ensure optimal acute care.