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.	李宁, 李新萍, 杨明辉, 等. 老年髋部骨折的骨质疏松症诊疗专家共识. 中华骨与关节外科杂志, 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, 胡三莲, 周玲, 等. 老年髋部骨折患者出院准备度的现况及影响因素分析. 中华现代护理杂志, 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.	张真容, 蒋佩, 罗玉琳. 基于德尔菲法构建中医护理岗位胜任力评价指标体系. 全科护理, 2023, 21(26): 3601-3605.
14.	叶繁. 脑卒中患者及照顾者出院准备现状与出院计划最佳证据总结. 蚌埠: 蚌埠医学院, 2022.
15.	胡慧秀, 孙超, 崔玲玲, 等. 出院准备服务在慢性心力衰竭患者中应用的最佳证据总结. 中国护理管理, 2020, 20(10): 1557-1563.
16.	杨雪凝. 基于循证构建老年 COPD 患者出院准备服务方案及实证研究. 蚌埠: 蚌埠医学院, 2022.
17.	胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 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, 张洋, 等. 294 例全髋关节置换术患者出院准备度现状及影响因素分析. 护理学报, 2021, 28(17): 59-63.
20.	陈琰琰, 陈侠, 刘晓莉, 等. 全髋关节置换患者出院准备度及其影响因素分析. 医院管理论坛, 2019, 36(5): 25-27, 19.
21.	段丹, 宁宁, 陈佳丽, 等. 关节置换术后患者出院准备度与出院指导质量的相关性研究. 华西医学, 2018, 33(9): 1181-1185.
22.	Hoffmann-Eßer 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.	顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价. 护士进修杂志, 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 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 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.	孙超, 奚桓, 李峥, 等. 老年患者出院准备服务专家共识(2019 版). 中华护理杂志, 2020, 55(2): 220-227.
30.	北京护理学会骨科专业委员会, 中华医学会骨科学分会护理学组, 中华医学会创伤学分会护理学组. 中国老年髋部骨折围手术期护理专家共识 (2023). 中华创伤骨科杂志, 2023, 25(5): 369-379.
31.	汪晖, 王颖, 刘于, 等. 住院患者出院计划关键任务的证据总结. 中华护理杂志, 2020, 55(9): 1412-1419.
32.	张咪, 周春兰, 吴艳妮, 等. 老年髋部骨折术后患者家庭康复护理的最佳证据总结. 中华护理杂志, 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. 家庭康复护理对老年髋部骨折病人术后康复效果影响的 Meta 分析. 循证护理, 2023, 9(5): 801-806.
35.	盖琼艳, 巫梦停, 李晨, 等. 出院准备服务对老年慢性病患者干预效果的系统评价. 中国循证医学杂志, 2020, 20(3): 289-295.
36.	夏维波, 章振林, 林华, 等. 原发性骨质疏松症诊疗指南(2017). 中国骨质疏松杂志, 2019, 25(3): 281-309.
37.	桑丽云, 商临萍. 我国出院准备度的研究现状. 护理研究, 2020, 34(1): 105-110.
38.	梁小芹, 邵小珍, 陶颖, 等. 老年髋部骨折患者照顾者延续护理需求的质性研究. 护理管理杂志, 2018, 18(2): 97-101.
39.	吴晓, 郝玉平. 基于 CiteSpace 出院准备服务的国内外研究现状及热点分析. 当代护士(下旬刊), 2022, 29(3): 45-51.
40.	中国营养学会骨营养与健康分会, 中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症患者的营养和运动管理专家共识. 中华骨质疏松和骨矿盐疾病杂志, 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.	姚宝红, 金博, 高晓云, 等. 老年脆性骨折患者再次骨折的危险因素. 中华老年多器官疾病杂志, 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. 李宁, 李新萍, 杨明辉, 等. 老年髋部骨折的骨质疏松症诊疗专家共识. 中华骨与关节外科杂志, 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, 胡三莲, 周玲, 等. 老年髋部骨折患者出院准备度的现况及影响因素分析. 中华现代护理杂志, 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. 张真容, 蒋佩, 罗玉琳. 基于德尔菲法构建中医护理岗位胜任力评价指标体系. 全科护理, 2023, 21(26): 3601-3605.
14. 叶繁. 脑卒中患者及照顾者出院准备现状与出院计划最佳证据总结. 蚌埠: 蚌埠医学院, 2022.
15. 胡慧秀, 孙超, 崔玲玲, 等. 出院准备服务在慢性心力衰竭患者中应用的最佳证据总结. 中国护理管理, 2020, 20(10): 1557-1563.
16. 杨雪凝. 基于循证构建老年 COPD 患者出院准备服务方案及实证研究. 蚌埠: 蚌埠医学院, 2022.
17. 胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 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, 张洋, 等. 294 例全髋关节置换术患者出院准备度现状及影响因素分析. 护理学报, 2021, 28(17): 59-63.
20. 陈琰琰, 陈侠, 刘晓莉, 等. 全髋关节置换患者出院准备度及其影响因素分析. 医院管理论坛, 2019, 36(5): 25-27, 19.
21. 段丹, 宁宁, 陈佳丽, 等. 关节置换术后患者出院准备度与出院指导质量的相关性研究. 华西医学, 2018, 33(9): 1181-1185.
22. Hoffmann-Eßer 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. 顾莺, 张慧文, 周英凤, 等. JBI 循证卫生保健中心关于不同类型研究的质量评价工具——系统评价的方法学质量评价. 护士进修杂志, 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 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 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. 孙超, 奚桓, 李峥, 等. 老年患者出院准备服务专家共识(2019 版). 中华护理杂志, 2020, 55(2): 220-227.
30. 北京护理学会骨科专业委员会, 中华医学会骨科学分会护理学组, 中华医学会创伤学分会护理学组. 中国老年髋部骨折围手术期护理专家共识 (2023). 中华创伤骨科杂志, 2023, 25(5): 369-379.
31. 汪晖, 王颖, 刘于, 等. 住院患者出院计划关键任务的证据总结. 中华护理杂志, 2020, 55(9): 1412-1419.
32. 张咪, 周春兰, 吴艳妮, 等. 老年髋部骨折术后患者家庭康复护理的最佳证据总结. 中华护理杂志, 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. 家庭康复护理对老年髋部骨折病人术后康复效果影响的 Meta 分析. 循证护理, 2023, 9(5): 801-806.
35. 盖琼艳, 巫梦停, 李晨, 等. 出院准备服务对老年慢性病患者干预效果的系统评价. 中国循证医学杂志, 2020, 20(3): 289-295.
36. 夏维波, 章振林, 林华, 等. 原发性骨质疏松症诊疗指南(2017). 中国骨质疏松杂志, 2019, 25(3): 281-309.
37. 桑丽云, 商临萍. 我国出院准备度的研究现状. 护理研究, 2020, 34(1): 105-110.
38. 梁小芹, 邵小珍, 陶颖, 等. 老年髋部骨折患者照顾者延续护理需求的质性研究. 护理管理杂志, 2018, 18(2): 97-101.
39. 吴晓, 郝玉平. 基于 CiteSpace 出院准备服务的国内外研究现状及热点分析. 当代护士(下旬刊), 2022, 29(3): 45-51.
40. 中国营养学会骨营养与健康分会, 中华医学会骨质疏松和骨矿盐疾病分会. 原发性骨质疏松症患者的营养和运动管理专家共识. 中华骨质疏松和骨矿盐疾病杂志, 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. 姚宝红, 金博, 高晓云, 等. 老年脆性骨折患者再次骨折的危险因素. 中华老年多器官疾病杂志, 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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