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10 pages/≈2750 words
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APA
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Health, Medicine, Nursing
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English (U.S.)
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Topic:
ACUTE ILLNESS (EPISODIC) Hip Replacement Nursing Care Management (Essay Sample)
Instructions:
FOCUS ON ACUTE ILLNESS (EPISODIC) OF HIP REPLACEMENT/ SURGERY/ ARTHROPLASTY
TRY TO GET RESOURCES FROM CANADA
Introduction
• Brief summary stating the overall goal of the paper
• Clearly states the focus of the paper and provides outline of the content to be included in the paper
• The topic is clearly identified
• The rationale for topic choice is clearly stated
Body of Paper
Literature Review & Critical Appraisal/ Analysis
• A review of the current nursing and health discipline literature about the health condition ( at least 10 scholarly). AT LEAST 5 PUBLICATION SHOULD BE FROM NURSES
• The focus should be on management, nursing care, interprofessional collaboration, and health promotion based on current evidenced-informed practice (CANADIAN clinical practice guidelines)
• For a critical appraisal of the literature reviewed- is there consistency in the recommendations or approaches identified in the literature? Do sources differ in recommendations? Are there gaps in the literature?
Clinical impact
• how the acute episodic illness impacts the client and family
• Social determinants of health, coping mechanisms, barriers
Health Promotion
source..
Content:
Acute Illness (Hip Injury) Hip Replacement Nursing Care Management
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Acute Illness (Hip Injury) Hip Replacement Nursing Care Management
The health care team experiences a considerable challenge when caring for patients with fragility fractures that occur below or at the standing height. These low-energy trauma fractures are regarded as illness of the old age affecting 12 % of males and 25 % of females above fifty years, and costs the healthcare of Canada about $ 2 billion yearly with a projection of tripling the costs due to the aging population in the next two decades (Sanders et al., 2021). Hip fracture constitutes the prevalent fragility fracture, and it is significantly associated with mortality and morbidity-related issues, with about thirty thousand individuals in Canada breaking their hip yearly with prior fracture preceding more than half of the cases. Primary total hip arthroplasty is a prevalent surgery conducted that improves the quality of life and mobilization in the affected individuals. Fast recovery occurs after hip replacement in most patients; however, some recover slowly and spend more time in the health care facility. Therefore, direly crucial to comprehend the critical nursing and inter-professional roles in promoting, preventing, and managing hip fractures. It often necessitates more guidance and education to initiate self-care, manage pain, and support, which requires multidisciplinary care to empower, engage, and improve patient satisfaction, enhancing recovery (Pulkkinen et al., 2020). This exposition focuses on evaluating literature related to a hip injury, critically analyzing the literature reviewed, the clinical impact of the illness, health promotion, inter-professional considerations, and discharge planning for the care of the affected patient.
Review of the Current Nursing and Health Discipline Literature
After the title and abstract review, a literature search was performed to identify relevant nursing articles related to the article review. Articles published within the last five years, English language, peer-reviewed, health disciplines nursing based, free access, and Canadian origin were preferred. The articles were searched in various databases, including Embase, PubMed, and google scholar Engine utilizing search terms and medical subject headings such as Acute illness, Hip replacement, Hip injuries, and arthroplasty and after inclusion and exclusion criteria, original studies, systematic reviews, reviews, and commentaries.
In a review performed by Sanders et al. (2021), the authors highlighted the present state of Canadian medical care for hip fractures, specifically aiming at the multidisciplinary team roles. It is indicated that the health care systems of Canada witness significant costs, mortality, and morbidity associated with hip fractures, and there exist gaps in management and care for the fragility fractures. These gaps present huge problem that often requires chronic and acute management and are augmented by inept ownership of fragility fractures by a medical specialty. The authors identify that the disparities can be solved by utilizing multidisciplinary teams due to cost-effectiveness and efficacious approach. Various barriers to patient care are identified through the interdisciplinary model of care, such as insufficient patient counseling, implying the need to identify patients at elevated risks and adherence to the treatment.
A commentary by Papaioannou et al. (2020) described the application of the Knowledge to action framework to direct the establishment and utilization of research evidence to prevent fractures in older individuals. The model is grounded on the aims of the Ontario Osteoporosis Strategy for Long Term Care (LTC) in supporting the reduction of fracture risks. Fractures are a significant source of morbidity in long-term care, as illustrated in the knowledge transition activities with considerable disparities in the therapy and assessment of risks, facilitators, and barriers to guide implementation. The multifaceted knowledge transition plans targeting staff in long-term care facilities encompass engagement, team-based action planning, audit, feedback, and education of health professionals, patient families, and LTC residents. The fracture rates were monitored from the provincial administrative database, and barriers and enablers to knowledge use included limited knowledge on the prevention, fracture risks, and osteoporosis. The decrease in the fracture rates in the LTC from 2.3 % to 1.9 % over the ten years implied the feasibility of multifaceted knowledge translation strategies in improving the uptake of the clinical recommendations for preventing fractures.
Another study involving co-management between a nurse and physician to improve the initiation of osteoporosis drugs after a fracture and cost-effectiveness were performed by Beaupre et al. (2020) and aimed to evaluate the 3i hip fracture liaison service (H-FLS) when implemented in the standard practice through co-management. The study had 1252 participants randomized into control and study groups and included in the H-FLS program throughout the study period. They were evaluated in a one-year follow-up period and assessed using a modeled cohort simulation cost-effectiveness. After the study period, in every one thousand patients included in the study program, the participants had 37 fewer fragility fractures and 12 fewer hip fractures with an elevated cost-effectiveness ratio compared to participants in the control group. Consequently, implementing the program in the standard practice resulted in enhanced anti-absorptive medication utilization suggesting the effectiveness in cost-effectiveness and reducing the risks of fractures.
In a narrative review conducted by Brent et al. (2018), the authors expound on the nurses’ roles within the orthogeriatric team and pinpoint the benefits of appropriate nursing care in enhancing patient outcomes. The crux of patient care with fragility fractures is enormous, especially acute, specifically for nurses who are required to provide complex care, coordinate care, and collaborate with patients with fractures around the clock and are in short supply. The authors elaborate on the nursing nature for fragility patients who anticipate coordinated, effective, and safe care across the interdisciplinary teams. It stipulates the necessity for specific geriatric and orthopedic nursing skills in conjunction with specialist education.
A descriptive qualitative study explored service recommendations provided by decision-makers, healthcare providers, caregivers, and patients in enhancing the transitions of care in older individuals with hip fractures. Cadel et al. (2022) used 47 older participants with hip fractures and care team in the care transition. They categorized the identified themes into three cross-sectoral-based recommendations, community-based recommendations, and hospital-based recommendations. Generally, the findings highlighted the importance of integrated care for hip fracture patients considering the likelihood of enhancing health outcomes and improving patient experiences through multidisciplinary approaches.
Critical Appraisal of the Literature Reviewed
There is a strong consistency in the evidence indicating the improvement of patient outcomes and reduction of fracture risks through the collaboration of various disciplines since care and management of fragility fractures involves multiple health professions and cannot occur in isolation. In most physicians and cases, nurses acting as case managers comprise the multidisciplinary team whose roles are complemented by other professionals such as occupational therapists and physiotherapists (Sanders et al., 2021). When nurses manage the interdisciplinary team, they form a crucial component in validating the efficacy of nurse-initiated approaches, especially in identifying patient risks contrasted to the physician-driven decision-making process. Similar recommendations arrived in a narrative review by Brent et al. (2018). They indicated that nurses’ interventions significantly influence the interdisciplinary team when maintaining and restoring the functional potential of patients with fragility fractures. The nursing team collaborates with therapists to ensure quick recovery of the patient from the immobility status, especially in older adults who experience adverse events weakened bone structures, increased respiratory infections, and reduced muscle strength due to immobility and bed rest.
Some studies differed in the criteria of recommendations highlighting their implementation to reduce fracture risks and promote care for patients with fragility fractures. The studies used frameworks and programs in Papaioannou et al. (2021) and Beaupre et al. (2020), respectively, while others focused on using the person-centered and multifaceted approaches to addressing the phenomenon as in Cadel et al. (2021) study. The framework allowed successful mobilization and knowledge translation via shareholder collaboration in action planning, developing clinical practice tools, and educational events for the patients to prevent future fragility fractures. The frameworks and programs also focused on improving medication compliance, increasing efficiency of care, skills, knowledge, and awareness of the providers are associated with a risk reduction of fractures, management, and care to foster sustained practice. In Cadel et al. (2021) actionable recommendations, the findings highlighted cross-sectional-based, hospital, and community recommendations which indicate the importance of community-based integrated care to hip fractures patients and the downstream need to address and act on the purported recommendations. The gap in the reviewed literature includes the generalizability of most of the studies across various age groups, limiting the potential to understand how health pro...
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