al (2009) that the annual number of hip fractures will increase from 23,375 in 1993/94 to 88,124in 2041.Patient profile:Audrey Smith an 87year old woman was admitted to acute care following a fall at home on30/10/11 when she lost her balance whilst helping her husband get dressed, as he suffers from
. She sustained a Left Femoral Fracture.
On admission Audrey’s Haemoglobin was 8.1, therefore 1 unit of blood was transfused prior to
theatre. Due to this
latency time (the time delay between the fracture incident andsurgery) was 2/3days. Hershkovitz et al (2007), using an inpatient rehabilitation survey on 133patients, found that patients with a latency time of more than 5days had a significantly longerlength of stay, affecting rehabilitation outcomes. Although
latency time was 2/3days(<5days), if her medical condition had of been stable on admission, then her surgical procedurecould have been preformed sooner. Orosz et al (2004) found that early surgical interventionresulted in better functional outcome, reduced mortality rate, shorter length of stay and a betterquality of life. Yet Grimes et al (2002) found no variation in mortality and morbidity in patientswho had surgery more than 96 hours after their hip fracture in comparison to those within 48hours.Audrey had a Left Femur IM Gamma Nail on 1/11/11. Post operatively she remained well andher observations were stable. She was deemed medically fit for further rehabilitation andtransferred to the Inpatient Rehabilitation Unit on 8/11/11. Gerold et al (2005) found that theshorter length of stay in acute surgical wards,
in Audrey’s case 10days
, results in efficient andrelatively brief rehabilitation programmes.The culture change of rehabilitation:An old historical study conducted by Agate (1985) reported that rehabilitation took place once allmedical or surgical treatment had stopped. However Gerold et al (2005) has reinforced thisculture change of rehabilitation from the third phase of medicine to being an integral part of acutenursing care, starting as early as possible,
with the stabilisation of Audrey’s medical condition
and the prevention of postoperative complications (Shabat et al 2005). Gerold et al (2005)reported that the need to be able to identify an
need for further rehabilitation in theacute setting is crucial, to enable the planning for an appropriate rehabilitation setting to begin.Spinks and Wasiak (2009) found that a Multidisciplinary approach adapted in the
homehas a greater chance of success. However in
case this was not feasible as she did nothave the presence of a caregiver or adequate social support.