TRANSITION CARE FOR OLDER ADULTS WITH HIP FRACTURE TO PREVENT VENOUS THROMBOEMBOLISM

2.50
Hdl Handle:
http://hdl.handle.net/10755/211577
Type:
Research Study
Title:
TRANSITION CARE FOR OLDER ADULTS WITH HIP FRACTURE TO PREVENT VENOUS THROMBOEMBOLISM
Abstract:
Background: Venous thromboembolism (VTE), manifesting in deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major health care concern in the United States (US).  The risk of VTE is highest in patients undergoing major surgery, particularly hip fracture surgery. Approximately 350,000 hip fractures occur in US annually. The mortality associated with hip fracture is notably high at 4-6% during hospitalization and dramatically increases at 1 year after discharge at14-36 %. Patients aged 65 years or older with hip fractures have the highest risk of VTE. While transitioning from acute healthcare settings to the community, elderly patients with hip fractures are especially vulnerable to undesirable outcomes due to fragmentation of services. Purpose: The purpose of the study is to evaluate informational needs of older hospitalized adults with hip fractures and their family caregivers. Methods: Older adults (≥65 years old) who received non-elective hip fracture surgery at a community hospital and their caregivers were asked to participate in the study. Inclusion criteria for this convenience sample were the ability to communicate in English, alert and oriented, and able to communicate by telephone. On the day of hospital discharge, participants answered questions regarding VTE risk, symptoms, anticoagulation, satisfaction with their care and educational information, and perceived needs for care after discharge. Participant medical records were also reviewed to identify underlying medical conditions, risk factors for VTE, and treatment during their hospitalization. Follow-up phone calls were conducted one month after discharge to identify adherence to anticoagulation therapy, functional assessment, and general medical conditions.  Results: The mean age was 79 years old (SD± 9) of 19 patient participants (14 females, 5 males). The majority had completed high school or higher education. Falling was the most common reason for hip fracture in this study population. Approximately 40% had cancer. Most patient participants had heard about DVT/PE (74%/95% patients, 82%/91% caregivers). Most participants (79%) were aware that immobility was a risk factor.  However, the participants had limited knowledge about signs and symptoms of DVT/PE. Participants were satisfied with their daily injections/oral medication but less satisfied with the information they received about side effects from their medication. The overall satisfaction of care and education was 73% among patients and 69% among caregivers. All patient participants received both pharmacological and mechanical treatment to prevent VTE during hospitalization. More than half of the patients planned to stay in a skilled nursing home for additional care after hospital discharge. Data collection is ongoing and more findings will be presented at the conference. Conclusions/Implications: The preliminary findings indicate that participants needed more education about the prevention of VTE in the transition period. Focused discharge education including during transition care should be considered in the development of a hip fracture program for older adults.
Keywords:
Venous thromboembolism; Deep vein thrombosis; Pulmonary embolism
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
5507
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleTRANSITION CARE FOR OLDER ADULTS WITH HIP FRACTURE TO PREVENT VENOUS THROMBOEMBOLISMen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211577-
dc.description.abstractBackground: Venous thromboembolism (VTE), manifesting in deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major health care concern in the United States (US).  The risk of VTE is highest in patients undergoing major surgery, particularly hip fracture surgery. Approximately 350,000 hip fractures occur in US annually. The mortality associated with hip fracture is notably high at 4-6% during hospitalization and dramatically increases at 1 year after discharge at14-36 %. Patients aged 65 years or older with hip fractures have the highest risk of VTE. While transitioning from acute healthcare settings to the community, elderly patients with hip fractures are especially vulnerable to undesirable outcomes due to fragmentation of services. Purpose: The purpose of the study is to evaluate informational needs of older hospitalized adults with hip fractures and their family caregivers. Methods: Older adults (≥65 years old) who received non-elective hip fracture surgery at a community hospital and their caregivers were asked to participate in the study. Inclusion criteria for this convenience sample were the ability to communicate in English, alert and oriented, and able to communicate by telephone. On the day of hospital discharge, participants answered questions regarding VTE risk, symptoms, anticoagulation, satisfaction with their care and educational information, and perceived needs for care after discharge. Participant medical records were also reviewed to identify underlying medical conditions, risk factors for VTE, and treatment during their hospitalization. Follow-up phone calls were conducted one month after discharge to identify adherence to anticoagulation therapy, functional assessment, and general medical conditions.  Results: The mean age was 79 years old (SD± 9) of 19 patient participants (14 females, 5 males). The majority had completed high school or higher education. Falling was the most common reason for hip fracture in this study population. Approximately 40% had cancer. Most patient participants had heard about DVT/PE (74%/95% patients, 82%/91% caregivers). Most participants (79%) were aware that immobility was a risk factor.  However, the participants had limited knowledge about signs and symptoms of DVT/PE. Participants were satisfied with their daily injections/oral medication but less satisfied with the information they received about side effects from their medication. The overall satisfaction of care and education was 73% among patients and 69% among caregivers. All patient participants received both pharmacological and mechanical treatment to prevent VTE during hospitalization. More than half of the patients planned to stay in a skilled nursing home for additional care after hospital discharge. Data collection is ongoing and more findings will be presented at the conference. Conclusions/Implications: The preliminary findings indicate that participants needed more education about the prevention of VTE in the transition period. Focused discharge education including during transition care should be considered in the development of a hip fracture program for older adults.en_GB
dc.subjectVenous thromboembolismen_GB
dc.subjectDeep vein thrombosisen_GB
dc.subjectPulmonary embolismen_GB
dc.date.available2012-02-20T12:03:17Z-
dc.date.issued2012-02-20T12:03:17Z-
dc.date.accessioned2012-02-20T12:03:17Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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