Application of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric hip fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Chaoqun , CHANG Yunhe , ZHENG Yang , WANG Zhiqian , LI Yujia , YANG Yajing ,  WANG Qingxian

Department of Geriatric Orthopedics, Traumatic Emergency Center, the Third Hospital of Hebei Medical University, Hebei Provincial Biomechancial Key Laboratory, Hebei Provincial Othopedic Institute, Shijiazhuang Hebei, 050051, P.R.China;

Corresponding?author：

WANG Qingxian, Email: wqxwx1028@163.com

Keywords：

Multidisciplinary team; doctor-nurse collaboration; geriatric hip fracture; perioperative period

DOI：

10.7507/1002-1892.201805068

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric patients with hip fractures.Methods The clinical data of 489 geriatric patients with hip fractures (femoral neck fracture and intertrochanteric fracture) between January 1st 2016 and January 1st 2018 was retrospectively analyzed. Among them, 279 patients were treated with the multidisciplinary doctor-nurse collaboration care (observation group) and 210 patients were treated with the conventional therapeutics and nursing care (control group). There was no significant difference in gender, age, cause of injury, type and classification of fracture, the interval between injury and admission, and Charlson index between the two groups (P>0.05). The surgery rates, time from hospitalization to operation, length of stay, and the incidences of perioperative complications were compared between the two groups.Results The surgery rate was 90.32% (252/279) in observation group and 80.48% (169/210) in control group, showing significant difference between the two groups (χ²=9.703, P=0.002). The time from hospitalization to operation and length of stay in observation group [(5.39±2.47), (10.56±3.76) days] were significant shorter than those in control group [(6.13±2.79), (12.27±3.11) days] (t=?3.075, P=0.002; t=?5.330, P=0.000). The incidence of respiratory complications was 46.15% in control group and 30.56% in observation group; the incidence of cardiovascular system complications was 69.23% in control group and 51.19% in observation group; the incidence of cerebrovascular system complications was 20.12% in control group and 11.11% in observation group; the incidence of deep venous thrombosis was 40.24% in control group and 25.40% in observation group. The incidences of perioperative complications were significantly lower in observation group than in control group (P<0.05).Conclusion Multidisciplinary doctor-nurse collaboration team is conducive not only to improve the surgery rates, but also to reduce perioperative complications as well as shorten the length of stay and preoperative waiting time.

Citation： WANG Chaoqun, CHANG Yunhe, ZHENG Yang, WANG Zhiqian, LI Yujia, YANG Yajing, WANG Qingxian. Application of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric hip fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(10): 1283-1286. doi: 10.7507/1002-1892.201805068 Copy

1.	劉粵, 郝瑋, 張巖, 等. 多學科協作綜合治療老年髖部骨折的療效. 中國老年學雜志, 2014, 34(19): 5481-5484.
2.	王國旗, 龍安華, 張立海, 等. 老年髖部骨折合并糖尿病患者圍手術期血糖水平對預后的影響. 中國修復重建外科雜志, 2014, 28(7): 844-847.
3.	王艷, 吳新, 湯根芬. 家庭訪視護理干預對老年髖部骨折術后病人生活質量的影響. 齊齊哈爾醫學院學報, 2012, 33(13): 1803-1805.
4.	方秀統, 張新, 王博, 等. 老年人髖部骨折術后死亡分析. 骨與關節損傷雜志, 2004, 19(7): 442-444.
5.	陳佳, 李西成. 髖部骨折: 爭議與挑戰. 中華老年骨科與康復電子雜志, 2017, 3(4): 193-196.
6.	賈學寬, 孫天勝. 血液指標對老年髖部骨折死亡率預測研究進展. 實用骨科雜志, 2015, 21(12): 1093-1095.
7.	Grass C, Umansky R. Problems in promoting the growth of multi-disciplinary diagnostic and counseling clinics for mentally retarded children in nonmetropolitan areas. Am J Public Health, 1971, 61(4): 698-710.
8.	Whitehouse M. A policy framework for commissioning cancer services. BMJ, 1995, 310(6992): 1425-1426.
9.	Althausen PL, Shannon S, Owens B, et al. Impact of hospital-employed physician assistants on a level Ⅱ community-based orthopaedic trauma system. J Orthop Trauma, 2016, 30(Spuppl 5): S40-S44.
10.	Soong C, Cram P, Chezar K, et al. Impact of an integrated hip fracture inpatient program on length of stay and costs. J Orthop Trauma, 2016, 30(12): 647-652.
11.	Christmas AB, Reynolds J, Hodges S, et al. Physician extenders impact trauma systems. J Trauma, 2005, 58(5): 917-920.
12.	Spisso J, O’Callaghan C, McKennan M, et al. Improved quality of care and reduction of housestaff workload using trauma nurse practitioners. J Trauma, 1990, 30(6): 660-663.
13.	Jarrett LA, Emmett M. Utilizing trauma nurse practitioners to decrease length of stay. J Trauma Nurs, 2009, 16(2): 68-72.
14.	Haan JM, Dutton RP, Willis M, et al. Discharge rounds in the 80-hour workweek: importance of the trauma nurse practitioner. J Trauma, 2007, 63(2): 339-343.
15.	Friedman SM, Mendelson DA, Bingham KW, et al. Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Arch Intern Med, 2009, 169(18): 1712-1717.
16.	Della Rocca GJ, Moylan KC, Crist BD, et al. Comanagement of geriatric patients with hip fractures: a retrospective, controlled, cohort study. Geriatr Orthop Surg Rehabil, 2013, 4(1): 10-15.
17.	Prestmo A, Hagen G, Sletvold O, et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet, 2015, 385(9978): 1623-1633.
18.	Nyberg SM, Keuter KR, Berg GM, et al. Acceptance of physician assistants and nurse practitioners in trauma centers. JAAPA, 2010, 23(1): 35-41.
19.	徐江波, 袁宏, 趙喜濱, 等. 520 例老年骨科患者圍手術期風險因素相關性分析. 新疆醫科大學學報, 2008, 31(10): 1382-1384.
20.	張靜梅, 張立濤, 梁俊生. 老年骨科患者并存內科系統疾病調查分析. 中國骨質疏松雜志, 2012, 18(4): 336-338.
21.	宋婷婷, 王新民, 畢希樂, 等. 老年髖部骨折圍術期心力衰竭的危險因素分析. 中華老年骨科與康復電子雜志, 2018, 4(1): 23-28.
22.	謝添, 馬彬彬, 李滎娟, 等. 加速康復外科在老年髖部骨折的研究現狀. 中國修復重建外科雜志, 2018, 32(8): 1038-1046.

1. 劉粵, 郝瑋, 張巖, 等. 多學科協作綜合治療老年髖部骨折的療效. 中國老年學雜志, 2014, 34(19): 5481-5484.
2. 王國旗, 龍安華, 張立海, 等. 老年髖部骨折合并糖尿病患者圍手術期血糖水平對預后的影響. 中國修復重建外科雜志, 2014, 28(7): 844-847.
3. 王艷, 吳新, 湯根芬. 家庭訪視護理干預對老年髖部骨折術后病人生活質量的影響. 齊齊哈爾醫學院學報, 2012, 33(13): 1803-1805.
4. 方秀統, 張新, 王博, 等. 老年人髖部骨折術后死亡分析. 骨與關節損傷雜志, 2004, 19(7): 442-444.
5. 陳佳, 李西成. 髖部骨折: 爭議與挑戰. 中華老年骨科與康復電子雜志, 2017, 3(4): 193-196.
6. 賈學寬, 孫天勝. 血液指標對老年髖部骨折死亡率預測研究進展. 實用骨科雜志, 2015, 21(12): 1093-1095.
7. Grass C, Umansky R. Problems in promoting the growth of multi-disciplinary diagnostic and counseling clinics for mentally retarded children in nonmetropolitan areas. Am J Public Health, 1971, 61(4): 698-710.
8. Whitehouse M. A policy framework for commissioning cancer services. BMJ, 1995, 310(6992): 1425-1426.
9. Althausen PL, Shannon S, Owens B, et al. Impact of hospital-employed physician assistants on a level Ⅱ community-based orthopaedic trauma system. J Orthop Trauma, 2016, 30(Spuppl 5): S40-S44.
10. Soong C, Cram P, Chezar K, et al. Impact of an integrated hip fracture inpatient program on length of stay and costs. J Orthop Trauma, 2016, 30(12): 647-652.
11. Christmas AB, Reynolds J, Hodges S, et al. Physician extenders impact trauma systems. J Trauma, 2005, 58(5): 917-920.
12. Spisso J, O’Callaghan C, McKennan M, et al. Improved quality of care and reduction of housestaff workload using trauma nurse practitioners. J Trauma, 1990, 30(6): 660-663.
13. Jarrett LA, Emmett M. Utilizing trauma nurse practitioners to decrease length of stay. J Trauma Nurs, 2009, 16(2): 68-72.
14. Haan JM, Dutton RP, Willis M, et al. Discharge rounds in the 80-hour workweek: importance of the trauma nurse practitioner. J Trauma, 2007, 63(2): 339-343.
15. Friedman SM, Mendelson DA, Bingham KW, et al. Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Arch Intern Med, 2009, 169(18): 1712-1717.
16. Della Rocca GJ, Moylan KC, Crist BD, et al. Comanagement of geriatric patients with hip fractures: a retrospective, controlled, cohort study. Geriatr Orthop Surg Rehabil, 2013, 4(1): 10-15.
17. Prestmo A, Hagen G, Sletvold O, et al. Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial. Lancet, 2015, 385(9978): 1623-1633.
18. Nyberg SM, Keuter KR, Berg GM, et al. Acceptance of physician assistants and nurse practitioners in trauma centers. JAAPA, 2010, 23(1): 35-41.
19. 徐江波, 袁宏, 趙喜濱, 等. 520 例老年骨科患者圍手術期風險因素相關性分析. 新疆醫科大學學報, 2008, 31(10): 1382-1384.
20. 張靜梅, 張立濤, 梁俊生. 老年骨科患者并存內科系統疾病調查分析. 中國骨質疏松雜志, 2012, 18(4): 336-338.
21. 宋婷婷, 王新民, 畢希樂, 等. 老年髖部骨折圍術期心力衰竭的危險因素分析. 中華老年骨科與康復電子雜志, 2018, 4(1): 23-28.
22. 謝添, 馬彬彬, 李滎娟, 等. 加速康復外科在老年髖部骨折的研究現狀. 中國修復重建外科雜志, 2018, 32(8): 1038-1046.

Chinese Journal of Reparative and Reconstructive Surgery

Application of multidisciplinary doctor-nurse collaboration team on the perioperation management of geriatric hip fractures

View correction

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content