Best evidence summary for discharge planning of elderly patients with hip fracture_West China Medical Journal

Authors：

HUANG Chun ^1,2 , ZHENG Xilin ^1,2 ,  PENG Lingli ¹ , TAO Zirong ¹

1. Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, Changsha, Hunan 410008, P. R. China;
2. Xiang Ya Nursing School, Central South University, Changsha, Hunan 410013, P. R. China;

Corresponding?author：

PENG Lingli, Email: lingli.peng@csu.edu.cn

Keywords：

Hip fracture; discharge planning; evidence summery; evidence-based nursing

DOI：

10.7507/1002-0179.202308223

Video：

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Objective To summarize the best evidence for discharge planning of elderly patients with hip fracture. Methods UpToDate, BMJ Best Practice, BMJ Evidence-Based Medicine, Guidelines International Network, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Agency for Healthcare Research and Quality, Scottish Intercollegiate Guidelines Network, Web of Science, PubMed, CINAHL, Embase, Cochrane Library, VIP data, China National Knowledge Infrastructure, SinoMed, Wanfang were searched by computer for literature about discharge planning of elderly patients with hip fracture. The retrieval time was from the establishment of the databases to July 31, 2023. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 15 articles were included, including 1 clinical decision, 3 guidelines, 3 expert consensuses, 4 evidence summaries, and 4 systematic reviews, covering 5 aspects of implementers and participants of discharge services, pre-discharge preparation during hospitalization, pre-discharge assessment, discharge guidance, and post-discharge follow-up. A total of 22 best evidences of discharge planning of elderly patients with hip fracture were extracted, including 15 A-level recommendations and 7 B-level recommendations. Conclusions There are many aspects involved in the discharge planning of elderly patients with hip fracture. In future clinical practice, healthcare professionals should develop individualized plans based on the actual conditions of each patient, aiming to meet their specific discharge needs. This approach can help reduce adverse outcomes such as recurrent fractures and readmission rates, while promoting better physical and mental recovery and facilitating the patient’s return to society.

Citation： HUANG Chun, ZHENG Xilin, PENG Lingli, TAO Zirong. Best evidence summary for discharge planning of elderly patients with hip fracture. West China Medical Journal, 2023, 38(10): 1503-1510. doi: 10.7507/1002-0179.202308223 Copy

1.	李寧, 李新萍, 楊明輝, 等. 老年髖部骨折的骨質疏松癥診療專家共識. 中華骨與關節外科雜志, 2021, 14(8): 657-663.
2.	Si L, Winzenberg TM, Jiang Q, et al. Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int, 2015, 26(7): 1929-1937.
3.	Hori K, Siu AM, Nguyen ET, et al. Osteoporotic hip fracture mortality and associated factors in Hawai’i. Arch Osteoporos, 2020, 15(1): 183.
4.	Brent L, Hommel A, Maher AB, et al. Nursing care of fragility fracture patients. Injury, 2018, 49(8): 1409-1412.
5.	Handoll H, Cameron ID, Mak JC, et al. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev, 2021, 11(11): CD007125.
6.	Odén A, McCloskey EV, Kanis JA, et al. Burden of high fracture probability worldwide: secular increases 2010-2040. Osteoporos Int, 2015, 26(9): 2243-2248.
7.	Meehan AJ, Maher AB, Brent L, et al. The international collaboration of orthopaedic nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture. Int J Orthop Trauma Nurs, 2019, 32: 3-26.
8.	何丹, 胡三蓮, 周玲, 等. 老年髖部骨折患者出院準備度的現況及影響因素分析. 中華現代護理雜志, 2020, 26(27): 3732-3737.
9.	Agency for Healthcare Research and Quality. Strategy 4: care transitions from hospital to home: IDEAL discharge planning (implementation handbook). Guide to patient and Family Engagement, 2023: 1-26.
10.	Earl T, Katapodis N, Schneiderman S, et al. Making healthcare safer Ⅲ: a critical analysis of existing and emerging patient safety practices: 15. care transitions. Rockville (MD): agency for healthcare research and quality (US), 2020: 1-41.
11.	Allsop S, Morphet J, Lee S, et al. Exploring the roles of advanced practice nurses in the care of patients following fragility hip fracture: a systematic review. J Adv Nurs, 2021, 77(5): 2166-2184.
12.	Zou D, Wang L, Li J, et al. The benefits of transitional care in older patients with chronic diseases: a systematic review and meta-analysis. Aging Clin Exp Res, 2022, 34(4): 741-750.
13.	張真容, 蔣佩, 羅玉琳. 基于德爾菲法構建中醫護理崗位勝任力評價指標體系. 全科護理, 2023, 21(26): 3601-3605.
14.	葉繁. 腦卒中患者及照顧者出院準備現狀與出院計劃最佳證據總結. 蚌埠: 蚌埠醫學院, 2022.
15.	胡慧秀, 孫超, 崔玲玲, 等. 出院準備服務在慢性心力衰竭患者中應用的最佳證據總結. 中國護理管理, 2020, 20(10): 1557-1563.
16.	楊雪凝. 基于循證構建老年 COPD 患者出院準備服務方案及實證研究. 蚌埠: 蚌埠醫學院, 2022.
17.	胡雁, 郝玉芳. 循證護理學. 2 版. 北京: 人民衛生出版社, 2018.
18.	DiCenso A, Bayley L, Haynes RB. ACP journal club. Editorial: accessing preappraised evidence: fine-tuning the 5S model into a 6S model. Ann Intern Med, 2009, 151(6): JC3-2, JC3-3.
19.	包良笑, 李婧, 張洋, 等. 294 例全髖關節置換術患者出院準備度現狀及影響因素分析. 護理學報, 2021, 28(17): 59-63.
20.	陳琰琰, 陳俠, 劉曉莉, 等. 全髖關節置換患者出院準備度及其影響因素分析. 醫院管理論壇, 2019, 36(5): 25-27, 19.
21.	段丹, 寧寧, 陳佳麗, 等. 關節置換術后患者出院準備度與出院指導質量的相關性研究. 華西醫學, 2018, 33(9): 1181-1185.
22.	Hoffmann-E?er W, Siering U, Neugebauer EA, et al. Guideline appraisal with AGREE Ⅱ: Systematic review of the current evidence on how users handle the 2 overall assessments. PLoS One, 2017, 12(3): e0174831.
23.	Aromataris E, Fernandez R, Godfrey CM, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an Umbrella review approach. Int J Evid Based Healthc, 2015, 13(3): 130-140.
24.	顧鶯, 張慧文, 周英鳳, 等. JBI 循證衛生保健中心關于不同類型研究的質量評價工具——系統評價的方法學質量評價. 護士進修雜志, 2018, 33(8): 701-703.
25.	McArthur A, Klugarová J, Florescu S. Chapter 4: systematic reviews of text and opinion//Aromataris E, Munn Z. JBI manual for evidence synthesis. JBI, 2020.
26.	王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
27.	Alper E, O’Malley TA, Greenwald J. Hospital discharge and readmission. UpToDate, 2023.
28.	NICE. Hip fracture: management. London: national institute for health and care excellence (NICE), 2023.
29.	孫超, 奚桓, 李崢, 等. 老年患者出院準備服務專家共識(2019 版). 中華護理雜志, 2020, 55(2): 220-227.
30.	北京護理學會骨科專業委員會, 中華醫學會骨科學分會護理學組, 中華醫學會創傷學分會護理學組. 中國老年髖部骨折圍手術期護理專家共識 (2023). 中華創傷骨科雜志, 2023, 25(5): 369-379.
31.	汪暉, 王穎, 劉于, 等. 住院患者出院計劃關鍵任務的證據總結. 中華護理雜志, 2020, 55(9): 1412-1419.
32.	張咪, 周春蘭, 吳艷妮, 等. 老年髖部骨折術后患者家庭康復護理的最佳證據總結. 中華護理雜志, 2022, 57(22): 2777-2783.
33.	Crotty M, Unroe K, Cameron ID, et al. Rehabilitation interventions for improving physical and psychosocial functioning after hip fracture in older people. Database Syst Rev, 2010(1): CD007624.
34.	袁建坤, 肖煌怡, 王峻. 家庭康復護理對老年髖部骨折病人術后康復效果影響的 Meta 分析. 循證護理, 2023, 9(5): 801-806.
35.	蓋瓊艷, 巫夢停, 李晨, 等. 出院準備服務對老年慢性病患者干預效果的系統評價. 中國循證醫學雜志, 2020, 20(3): 289-295.
36.	夏維波, 章振林, 林華, 等. 原發性骨質疏松癥診療指南(2017). 中國骨質疏松雜志, 2019, 25(3): 281-309.
37.	桑麗云, 商臨萍. 我國出院準備度的研究現狀. 護理研究, 2020, 34(1): 105-110.
38.	梁小芹, 邵小珍, 陶穎, 等. 老年髖部骨折患者照顧者延續護理需求的質性研究. 護理管理雜志, 2018, 18(2): 97-101.
39.	吳曉, 郝玉平. 基于 CiteSpace 出院準備服務的國內外研究現狀及熱點分析. 當代護士(下旬刊), 2022, 29(3): 45-51.
40.	中國營養學會骨營養與健康分會, 中華醫學會骨質疏松和骨礦鹽疾病分會. 原發性骨質疏松癥患者的營養和運動管理專家共識. 中華骨質疏松和骨礦鹽疾病雜志, 2020, 13(5): 396-410.
41.	Adler-Milstein J, Raphael K, O’Malley TA, et al. Information sharing practices between US hospitals and skilled nursing facilities to support care transitions. JAMA Netw Open, 2021, 4(1): e2033980.
42.	姚寶紅, 金博, 高曉云, 等. 老年脆性骨折患者再次骨折的危險因素. 中華老年多器官疾病雜志, 2023, 22(4): 241-245.
43.	Riester MR, Beaudoin FL, Joshi R, et al. Evaluation of post-acute care and one-year outcomes among medicare beneficiaries with hip fractures: a retrospective cohort study. BMC Med, 2023, 21(1): 232.

1. 李寧, 李新萍, 楊明輝, 等. 老年髖部骨折的骨質疏松癥診療專家共識. 中華骨與關節外科雜志, 2021, 14(8): 657-663.
2. Si L, Winzenberg TM, Jiang Q, et al. Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int, 2015, 26(7): 1929-1937.
3. Hori K, Siu AM, Nguyen ET, et al. Osteoporotic hip fracture mortality and associated factors in Hawai’i. Arch Osteoporos, 2020, 15(1): 183.
4. Brent L, Hommel A, Maher AB, et al. Nursing care of fragility fracture patients. Injury, 2018, 49(8): 1409-1412.
5. Handoll H, Cameron ID, Mak JC, et al. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev, 2021, 11(11): CD007125.
6. Odén A, McCloskey EV, Kanis JA, et al. Burden of high fracture probability worldwide: secular increases 2010-2040. Osteoporos Int, 2015, 26(9): 2243-2248.
7. Meehan AJ, Maher AB, Brent L, et al. The international collaboration of orthopaedic nursing (ICON): Best practice nursing care standards for older adults with fragility hip fracture. Int J Orthop Trauma Nurs, 2019, 32: 3-26.
8. 何丹, 胡三蓮, 周玲, 等. 老年髖部骨折患者出院準備度的現況及影響因素分析. 中華現代護理雜志, 2020, 26(27): 3732-3737.
9. Agency for Healthcare Research and Quality. Strategy 4: care transitions from hospital to home: IDEAL discharge planning (implementation handbook). Guide to patient and Family Engagement, 2023: 1-26.
10. Earl T, Katapodis N, Schneiderman S, et al. Making healthcare safer Ⅲ: a critical analysis of existing and emerging patient safety practices: 15. care transitions. Rockville (MD): agency for healthcare research and quality (US), 2020: 1-41.
11. Allsop S, Morphet J, Lee S, et al. Exploring the roles of advanced practice nurses in the care of patients following fragility hip fracture: a systematic review. J Adv Nurs, 2021, 77(5): 2166-2184.
12. Zou D, Wang L, Li J, et al. The benefits of transitional care in older patients with chronic diseases: a systematic review and meta-analysis. Aging Clin Exp Res, 2022, 34(4): 741-750.
13. 張真容, 蔣佩, 羅玉琳. 基于德爾菲法構建中醫護理崗位勝任力評價指標體系. 全科護理, 2023, 21(26): 3601-3605.
14. 葉繁. 腦卒中患者及照顧者出院準備現狀與出院計劃最佳證據總結. 蚌埠: 蚌埠醫學院, 2022.
15. 胡慧秀, 孫超, 崔玲玲, 等. 出院準備服務在慢性心力衰竭患者中應用的最佳證據總結. 中國護理管理, 2020, 20(10): 1557-1563.
16. 楊雪凝. 基于循證構建老年 COPD 患者出院準備服務方案及實證研究. 蚌埠: 蚌埠醫學院, 2022.
17. 胡雁, 郝玉芳. 循證護理學. 2 版. 北京: 人民衛生出版社, 2018.
18. DiCenso A, Bayley L, Haynes RB. ACP journal club. Editorial: accessing preappraised evidence: fine-tuning the 5S model into a 6S model. Ann Intern Med, 2009, 151(6): JC3-2, JC3-3.
19. 包良笑, 李婧, 張洋, 等. 294 例全髖關節置換術患者出院準備度現狀及影響因素分析. 護理學報, 2021, 28(17): 59-63.
20. 陳琰琰, 陳俠, 劉曉莉, 等. 全髖關節置換患者出院準備度及其影響因素分析. 醫院管理論壇, 2019, 36(5): 25-27, 19.
21. 段丹, 寧寧, 陳佳麗, 等. 關節置換術后患者出院準備度與出院指導質量的相關性研究. 華西醫學, 2018, 33(9): 1181-1185.
22. Hoffmann-E?er W, Siering U, Neugebauer EA, et al. Guideline appraisal with AGREE Ⅱ: Systematic review of the current evidence on how users handle the 2 overall assessments. PLoS One, 2017, 12(3): e0174831.
23. Aromataris E, Fernandez R, Godfrey CM, et al. Summarizing systematic reviews: methodological development, conduct and reporting of an Umbrella review approach. Int J Evid Based Healthc, 2015, 13(3): 130-140.
24. 顧鶯, 張慧文, 周英鳳, 等. JBI 循證衛生保健中心關于不同類型研究的質量評價工具——系統評價的方法學質量評價. 護士進修雜志, 2018, 33(8): 701-703.
25. McArthur A, Klugarová J, Florescu S. Chapter 4: systematic reviews of text and opinion//Aromataris E, Munn Z. JBI manual for evidence synthesis. JBI, 2020.
26. 王春青, 胡雁. JBI 證據預分級及證據推薦級別系統(2014 版). 護士進修雜志, 2015, 30(11): 964-967.
27. Alper E, O’Malley TA, Greenwald J. Hospital discharge and readmission. UpToDate, 2023.
28. NICE. Hip fracture: management. London: national institute for health and care excellence (NICE), 2023.
29. 孫超, 奚桓, 李崢, 等. 老年患者出院準備服務專家共識(2019 版). 中華護理雜志, 2020, 55(2): 220-227.
30. 北京護理學會骨科專業委員會, 中華醫學會骨科學分會護理學組, 中華醫學會創傷學分會護理學組. 中國老年髖部骨折圍手術期護理專家共識 (2023). 中華創傷骨科雜志, 2023, 25(5): 369-379.
31. 汪暉, 王穎, 劉于, 等. 住院患者出院計劃關鍵任務的證據總結. 中華護理雜志, 2020, 55(9): 1412-1419.
32. 張咪, 周春蘭, 吳艷妮, 等. 老年髖部骨折術后患者家庭康復護理的最佳證據總結. 中華護理雜志, 2022, 57(22): 2777-2783.
33. Crotty M, Unroe K, Cameron ID, et al. Rehabilitation interventions for improving physical and psychosocial functioning after hip fracture in older people. Database Syst Rev, 2010(1): CD007624.
34. 袁建坤, 肖煌怡, 王峻. 家庭康復護理對老年髖部骨折病人術后康復效果影響的 Meta 分析. 循證護理, 2023, 9(5): 801-806.
35. 蓋瓊艷, 巫夢停, 李晨, 等. 出院準備服務對老年慢性病患者干預效果的系統評價. 中國循證醫學雜志, 2020, 20(3): 289-295.
36. 夏維波, 章振林, 林華, 等. 原發性骨質疏松癥診療指南(2017). 中國骨質疏松雜志, 2019, 25(3): 281-309.
37. 桑麗云, 商臨萍. 我國出院準備度的研究現狀. 護理研究, 2020, 34(1): 105-110.
38. 梁小芹, 邵小珍, 陶穎, 等. 老年髖部骨折患者照顧者延續護理需求的質性研究. 護理管理雜志, 2018, 18(2): 97-101.
39. 吳曉, 郝玉平. 基于 CiteSpace 出院準備服務的國內外研究現狀及熱點分析. 當代護士(下旬刊), 2022, 29(3): 45-51.
40. 中國營養學會骨營養與健康分會, 中華醫學會骨質疏松和骨礦鹽疾病分會. 原發性骨質疏松癥患者的營養和運動管理專家共識. 中華骨質疏松和骨礦鹽疾病雜志, 2020, 13(5): 396-410.
41. Adler-Milstein J, Raphael K, O’Malley TA, et al. Information sharing practices between US hospitals and skilled nursing facilities to support care transitions. JAMA Netw Open, 2021, 4(1): e2033980.
42. 姚寶紅, 金博, 高曉云, 等. 老年脆性骨折患者再次骨折的危險因素. 中華老年多器官疾病雜志, 2023, 22(4): 241-245.
43. Riester MR, Beaudoin FL, Joshi R, et al. Evaluation of post-acute care and one-year outcomes among medicare beneficiaries with hip fractures: a retrospective cohort study. BMC Med, 2023, 21(1): 232.

West China Medical Journal

Best evidence summary for discharge planning of elderly patients with hip fracture

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