ELDERLY PATIENTS WITH HIP-FRACTURES - IMPROVED OUTCOME WITH THE USE OF CARE MAPS WITH HIGH-QUALITY MEDICAL AND NURSING PROTOCOLS

In a prospective cohort study, 51 patients were treated with standard nursing and medical treatment after sustaining a hip fracture. A secon d group of 55 patients was treated with high-quality medical and nursi ng protocols outlined on our care map. The patient groups showed no si gnificant differences preoperatively in terms of the important variabl es of age, mental status, marital status, accommodation, ambulation, f racture type or fracture treatment. Postoperatively the patients were followed for a 6-month outcome. The outcome of return to their place o f accommodation and their previous level of function was considered gr ade 1. In grade 2, the patients lost one level of function or one leve l of accommodation. In grade 3 they lost one level of accommodation an d one level of function. In grade 4 they were dead. Overall we were ab le to show that the patients in the study group had a statistically si gnificantly better outcome (p = 0.036). In addition, they had signific antly fewer postoperative complications (p = 0.01) and a significantly greater number of the patients returned home within 14 days of their admission. We feel that the medical and nursing protocols outlined are generally applicable and could significantly improve the outcome over all for elderly patients with fractured hips.