Nursing Care after Hip Fracture Surgery Predicts Patient Ambulatory Ability at 3 Months after Surgery
|Akiko Kondo1*, Keiko Sada2, Chikae Yamaguchi3 and Etsuko Fujimoto4|
|1School of Nursing, Graduate School of Nursing, Tokyo Women’s Medical University, Japan|
|2Orthopedic Unit, Kasugai Municipal Hospital, Japan|
|3School of Nursing, Nagoya City University, Japan|
|4Department of Nursing, Nagoya University Graduate School of Medicine, Japan|
|Corresponding Author :||Akiko Kondo, RN, PhD
School of Nursing, Graduate School of Nursing
Tokyo Women’s Medical University, Tokyo, Japan
Tel: +81-3-3357-4804 (ext.6267)
E-mail: [email protected]
|Received September 30, 2012; Accepted October 30, 2012; Published November 03, 2012|
|Citation: Kondo A, Sada K, Yamaguchi C, Fujimoto E (2012) Nursing Care after Hip Fracture Surgery Predicts Patient Ambulatory Ability at 3 Months after Surgery. J Nurs Care S5:002. doi:10.4172/2167-1168.S5-002|
|Copyright: © 2012 Kondo A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Purpose: This study examines whether nursing care predicts the incidence of complications, mortality, ambulatory ability at discharge and 3 months after surgery or the length of stay for patients who have undergone hip fracture surgery.
Methods: This is a retrospective observational study conducted at a community general hospital in Japan. Participants were patients who were 65 years or older and who had hip fracture surgery during the study period, April 2007 to March 2011. Data on demographics, treatments, nursing care and health outcomes during the hospital stay were collected from hospital records. A questionnaire regarding the patient’s health outcomes after discharge was sent to patients and/or family members.
Results: In all, 449 patients met the inclusion criteria. The average age was 81.9 years, and 79.0% were female. In total, 94.4% of the patients were recorded as having obtained nursing care for getting out of bed, and 47.7% were recorded as having obtained nursing care for bearing weight. Nursing care associated with the topic “tell patients the necessity of getting out of bed early or encourage patients to get out of bed” were significantly related to a lower incidence of complication (OR=0.341, P=0.017). Patients with recorded nursing care for weight bearing had significantly greater ambulatory ability at discharge after adjusting for the introduction of the fixed-payment system, patient characteristics, type of surgery, hours of physical therapy and length of stay before surgery (OR=1.890, P=0.006). Patients with recorded nursing care for weight bearing had significantly greater ambulatory ability at 3 months after adjusting for the same covariates (OR=2.175, P=0.008).
Conclusion: Nursing care soon after surgery in an acute care hospital can improve the long-term outcomes of patients after they undergo hip fracture surgery. In addition to physical therapists, nurses should more willingly engage in the rehabilitation of patients in the orthopedic wards.