Department of Internal Medicine Residency, SAUSHEC, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, San Antonio, TX, USA.
Department of Endocrinology, SAUSHEC, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, San Antonio, TX, USA.
Osteoporos Int. 2018 Jun;29(6):1295-1301. doi: 10.1007/s00198-018-4416-x. Epub 2018 Feb 20.
Osteoporotic hip fractures can be life changing and can increase mortality. Treatment of osteoporosis following hip fracture is often delayed. We began offering osteoporosis medication during hospitalization for hip fracture, dramatically increasing the number of patients meeting standard of care.
Osteoporotic hip fracture is a debilitating condition with major morbidity and mortality implications. Osteoporosis medication given within 90 days of hip fracture improves mortality and reduces risk of future fractures. The aim of this project was to improve rates of timely osteoporosis treatment following fragility hip fracture.
This was a two-step intervention utilizing the Plan-Do-Study-Act cycle, beginning with resident-focused education in cycle 1. In cycle 2, we offered osteoporosis medication to inpatients for hip fracture with help from a new electronic order set.
Prior to this intervention, 32% of patients received osteoporosis medication within 90 days of fragility hip fracture; this improved to 81% after intervention.
Resident education and an electronic order set dramatically improved the percentage of patients meeting standard of care with osteoporosis pharmacotherapy following fragility fracture.
骨质疏松性髋部骨折可能改变患者的生活，并增加死亡率。髋部骨折后治疗骨质疏松症常常被延迟。我们开始在髋部骨折住院期间提供骨质疏松症药物治疗，这显著增加了符合护理标准的患者数量。
骨质疏松性髋部骨折是一种使人衰弱的疾病，具有重大的发病率和死亡率影响。髋部骨折后 90 天内给予骨质疏松症药物可改善死亡率并降低未来骨折的风险。该项目的目的是提高脆性髋部骨折后及时治疗骨质疏松症的比率。
这是一个利用计划-执行-研究-行动循环的两步干预措施，在第 1 周期中从住院医师的教育开始。在第 2 周期中，我们使用新的电子医嘱集为髋部骨折的住院患者提供骨质疏松症药物治疗。
在干预之前，只有 32%的脆性髋部骨折患者在 90 天内接受骨质疏松症药物治疗；干预后，这一比例提高到 81%。
住院医师教育和电子医嘱集极大地提高了脆性骨折后骨质疏松症药物治疗符合护理标准的患者比例。
