NHS trusts join forces to improve care for hip fracture patients
Airedale NHS Foundation Trust has joined forces with five other NHS trusts to support hip fracture patients with an initiative that has been shown to save lives, giving those patients greater independence and helping them return home.
The safety collaborative seeks to improve care for these patients, often elderly, through the introduction of dedicated nutritional assistants on acute trauma wards, improving their nutrition to aid their recovery.
Eloise Hill-Crane is the nutritional assistant currently working on the orthopaedic ward at Airedale Hospital and explains the benefits of the new role:
“As a nutritional assistant it’s my role to improve patient’s nutritional intake by making sure the correct meals are ordered, that patients have help to eat, making sure they are positioned properly and encouraging them with their food and supporting staff on the ward.
In the recovery time patients with a fractured femur need energy through calories, a high protein diet for recovery of their muscles and tissues after their operation. They need fluid for hydration and to prevent pressure ulcers because they are in bed a long time. They would have had to fast prior to the operation so won’t have eaten for a long time and so their bodies are really low on stores. The age range of those patients are at a higher risk of malnutrition while they are in hospital, around 40% are at risk before they come in and when they fast for 6 hours before their surgery, it is really crucial that we are fuelling their bodies with enough calories, energy and protein to recover. Good nutrition and good hydration can reduce confusion and delirium after an operation and in turn reduce the risk of falling. It is also better in terms of their physiotherapy afterwards, they will have more energy.”
Nick Bergin, Specialist Nutrition Support Dietitian and Acute Team Leader at Airedale NHS Foundation Trust said: “We are delighted to be part of this safety programme which will help us to improve care for our patients and support further adoption across the NHS, so that many more patients can benefit in the future.
“By joining forces and working together, I am confident that we will be able to benefit many more patients and families beyond our local area.”
This project is going to really improve patient outcomes and reduce length of stay in hospital. It will improve their overall nutritional status. It is a really exciting project to be involved in, we are only one of six trusts nationally signed up to this.”
Hip fracture is the most common serious injury in older people and ward-based, dedicated nutritional support has been demonstrated to have a significant impact on recovery following a hip fracture. HIP QIP 2 follows a successful scheme run by Northumbria Healthcare in 2016, in which the use of dedicated assistants to provide extra nutrition to patients resulted in a decrease in 30-day mortality from 10.3% to 5.7% over the course of the project, meaning an additional 119 lives were saved. There, five nutritional assistants were recruited, leading to an extra 29,000 meals being provided. In addition to the lives saved, an extra 200 people returned to their own homes than would previously have been the case.
Professor Mike Reed, clinical director for trauma and orthopaedics at Northumbria Healthcare and co-lead for the HIP QIP 2 collaborative, said: “The overall ambition of this collaborative is to prove the case that through the introduction of a proven intervention of additional nutritional support we can save lives, secure greater independence for those who facture their hip, and financially incentivise NHS organisations through attainment of BPT (best practice tariff), to make nutritional assistants a routine member of their ward teams.
“By coming together and sharing best practice, I strongly believe we can make a real difference to patients across the NHS.”