MacDonald Valerie, Maher Ann Butler, Mainz Hanne, Meehan Anita J, Brent Louise, Hommel Ami, Hertz Karen, Taylor Anita, Sheehan Katie Jane
Valerie MacDonald, MSN, Adjunct Professor, BC Hip Fracture Redesign Initiative, UBC School of Nursing, Vancouver, British Columbia, Canada. Ann Butler Maher, MS, RN, FNP-BC (Retired), ICON Ambassador, Long Branch, NJ. Hanne Mainz, PhD, MHS, RN, Clinical Nurse Specialist, Orthopaedic Department, Arhaus University Hospital, Arhaus, Denmark. Anita J. Meehan, MSN, RN-BC, ONC, FNGNA, Clinical Nurse Specialist, Gerontology, Cleveland Clinic Akron General, Akron, OH. Louise Brent, MSc, RGN, RNP, Irish Hip Fracture Database Audit Coordinator, National Office of Clinical Audit, Royal College of Surgeons in Ireland, Dublin, Ireland. Ami Hommel, PhD, CNS, RN, Associate Professor, Malmö University, Malmö, Sweden; and Skane University Hospital, Lund, Sweden. Karen Hertz, MSc, DPSN, RGN, Advanced Nurse Practitioner, University Hospital of North Midlands, NHS Trust, Stoke on Trent Staffordshire, United Kingdom. Anita Taylor, MCISc, MNSc, GradDipOrtho, OrthoCert, RN, Orthopaedic Nurse Practitioner, Orthopaedic & Trauma Unit, Royal Adelaide Hospital, Adelaide, South Australia. Katie Jane Sheehan, PhD, PT, Academic Department of Physiotherapy, Division of Health and Social Care Research, Kings College, London, United Kingdom.
Orthop Nurs. 2018 Mar/Apr;37(2):115-121. doi: 10.1097/NOR.0000000000000431.
Fragility hip fracture in older adults often has poor outcomes, but these outcomes can be improved with attention to specific quality care indicators.
The International Collaboration of Orthopaedic Nursing (ICON) developed an audit process to identify the extent to which internationally accepted nursing quality care indicators for older adults with fragility hip fracture are reflected in policies, protocols, and processes guiding acute care.
A data abstraction tool was created for each of 12 quality indicators. Data were collected using a mixed-methods approach with unstructured rounds. A rationale document providing evidence for the quality indicators and a user evaluation form were included with the audit tool. A purposeful sample of 35 acute care hospitals representing 7 countries was selected.
Thirty-five hospitals (100%) completed the survey. Respondents viewed the content as relevant and applicable for the defined patient population. Although timing and frequency of implementation varied among and within countries, the identified quality indicators were reflected in the majority of policies, protocols, or processes guiding care in the hospitals surveyed.
Developing and testing an audit of nurse-sensitive quality indicators for older adults with fragility hip fracture demonstrate international consensus on common core best practices to ensure optimal acute care.
老年人髋部脆性骨折的预后通常较差，但关注特定的优质护理指标可改善这些预后。
国际骨科护理协作组织（ICON）制定了一个审核流程，以确定国际认可的针对髋部脆性骨折老年人的护理质量指标在指导急性护理的政策、方案和流程中的体现程度。
为12项质量指标中的每一项创建了一个数据提取工具。采用非结构化查房的混合方法收集数据。审核工具中包含一份为质量指标提供证据的理论依据文件和一份用户评估表。选取了代表7个国家的35家急性护理医院作为有目的的样本。
35家医院（100%）完成了调查。受访者认为该内容与定义的患者群体相关且适用。尽管各国之间以及各国国内实施的时间和频率有所不同，但在所调查医院的大多数指导护理的政策、方案或流程中都体现了所确定的质量指标。
为髋部脆性骨折老年人开发并测试护士敏感质量指标审核，证明了在确保最佳急性护理的共同核心最佳实践方面存在国际共识。
