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This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.
Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
Secondary Fracture Prevention: An International Perspective presents practitioners and academic clinicians with a better understanding of secondary fracture prevention and models of care from a variety of settings and countries. This must-have guide provides practitioners and academic clinicians with essential information about this broad clinical and research topic that extends across the globe. Preventing secondary fractures starts with assessing what works and what does not work, reviewing major society guidelines, and what workup and management is necessary. This book reviews these topics and provides the rationale for pursuing a workup to prevent fractures in this patient population.
This second edition, in Open Access, aims to provide a comprehensive and practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture, with additional focus on those who are frail. It considers this from the perspectives of all the clinical and home care settings in which this group of patients receive care and is relevant to all global locations. The concept of orthogeriatric care is explored in detail. Global estimates suggest that there were 21 million men and 137 million women aged 50 years or more at high fracture risk in 2010. This incidence is expected to double by 2040, with the most significant increase in Asia. Fragility fracture is one of the foremost challenges for health care providers and thehe global demand for nursing care for patients with fragility fractures across the world is immense. Hip fracture is particularly challenging as these significant injuries often occur in frail older people requiring hospitalisation and orthopaedic surgery. Such injuries and associated surgery result in increased frailty, worsening health and wellbeing, pain, disability, reduced quality of life, loss of independence, and decreased life expectancy. Care providers need to understand the experience of fragility fracture from the perspective of patients and families so that direct improvements in care can be based on the perspectives of the users. Expert care of patients following fractures that require hospitalisation and orthopaedic surgery involves skill in the care and treatment of frail older people as we as individuals with an injury and undergoing surgery. Nurses have a significant role in interdisciplinary collaborative care provided through orthogeriatric models of care. There is increasing evidence that such models significantly improve patient outcomes. High quality, evidence-based orthogeriatric care is increasingly shown to have positive impact on outcomes for recovery, rehabilitation, and secondary prevention of further fracture. This book significantly supports the aims and values of the Fragility Fracture Network and, as such, supports the learning needs of nurses and other allied health professionals which will enable a comprehensive approach to nursing practice in orthogeriatric and fragility fracture care.
This book offers an up-to-date review on the principles and practice of multidimensional assessment and management of the older individual, which represents the cornerstone of modern clinical practice in the elderly. The early chapters cover the main elements and scope of the comprehensive geriatric approach and explain the pathways of care from screening and case finding through to in-depth assessment and treatment planning. Subsequent chapters review the evidence of how best to apply the multidimensional assessment and management approach in defined healthcare settings and within specific clinical areas, such as cancer and surgery. Finally, the education and training challenges are reviewed and the prospects for future clinical service and research in this important field are examined. The book is very timely given the recent advances in application of this approach, which reflect the growing international realization that older people are “core business” in many clinical areas where the role of specialist geriatric medicine has hitherto been limited. Accordingly, the book will be relevant to a wide range of clinicians. The authorship comprises many of the best known and widely published experts in their respective fields.
Orthopaedic and Trauma Nursing provides practitioners working in orthopaedic and musculoskeletal trauma settings with the essential evidence, guidance and knowledge required to underpin effective practice. This comprehensive and contemporary textbook explores the variety of adult and paediatric clinical settings where orthopaedic and trauma practitioners work, including acute wards, clinics, community hospitals, nursing homes and patients' homes. Divided into 5 sections, this book looks at: key issues in orthopaedic and musculoskeletal trauma care; specialist practice issues; common orthopaedic conditions and their care and management; musculoskeletal trauma care; and care of children and young people. Suitable for students at degree level as well as those clinicians practicing in more advanced orthopaedic and trauma care roles, Orthopaedic and Trauma Nursing is a foremost authority on orthopaedic and musculoskeletal practice for both students and practitioners. Orthopaedic and Trauma Nursing: Is strongly supported by the latest evidence, with chapters summarizing evidence, with reference to relevant and seminal research Offers practical guidance based on the relevant evidence Focuses on the perspective of the patient with patient narrative and case studies throughout Includes a section specifically dealing with children and young people
With an ageing population, there is little doubt that the majority of hospital-based consultants and their teams will care for older patients and the many complications this presents. This book provides an evidence-based guide for both trainees and consultants in geriatric medicine and those interested in geriatric medicine. Designed in line with the core Royal College curriculum, it provides a comprehensive and relevant guide to the issues seen in everyday geriatric medicine practice across the world. Presented in an easy-to-use double page spread format, highly bulleted and concise, Oxford Desk Reference: Geriatric Medicine is ideal for quick referral for both trainees and consultants. Contributions from the leading figures in geriatric medicine throughout the world make this book indispensable for all those working in the field, and for all those who have to deal with older patients.
Thanks to an increasing life expectancy of our populations the number of elderly persons is steadily growing and will continue to do so. Among these, the rate of persons with illnesses and degenerative diseases is significant. The prevalence of osteoporosis is especially high in elderly women and leads to typical fracture patterns. Hip fractures, proximal humerus fractures, distal radius fractures and fractures of the vertebral column are the most common. In the last decade, we are confronted with a sharp increase of fragility fractures of the pelvis. Until now, there is no consensus on how to identify and classify these lesions and there are no guidelines for treatment and after treatment. In particular, there is no common view on which patients need an operative treatment and which technique of osteosynthesis should be used. This book fills the gap in available literature and gives a state of the art guide to the treatment of fragility fractures of the pelvis. With the sharp increase of these fractures and the lacking consensus, Fragility Fractures of the Pelvis will become indispensable for the physicians who take care of elderly patients with this pathology. Written by a team of expert opinion leaders, the aim of this book is to contribute to the scientific discussion in this area and to help provide the optimal care for these patients.