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Treatment of pain for older hip fracture patients across settings
Karen S Feldt1, Joan Gunderson
1School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
Purpose:
To examine the treatment of pain following hip fracture across settings (hospital to nursing home or rehabilitation facility).
Design:
This was a secondary data analysis of two survey design studies that collected data on hip fracture patients in the hospital and for posthospital days at an institutional setting.
Sample:
115 subjects, 65 years or older, who had undergone surgical treatment of a hip fracture.
Methods:
Medical records were reviewed to compare the amount of pain medication administered to postoperative hip fracture elders during the last 24 hours in the hospital with that of the first 24 hours in the nursing home (NH).
Findings:
The mean length of stay following surgery was 4.8 days. Subjects received significantly less medication during the first 24 hours in the NH as compared with the last 24 hours of hospitalization. Over one third (37.4%) of the subjects received no opioid analgesic and 18.3% (n = 21) received no analgesic of any kind during the first 24 hours of NH stay.
Implications:
Rather than simply listing medications orders, hospital nursing staff should communicate type, amount, frequency and efficacy of pain medication in transfer notes to nursing home staff. Nursing home staff would benefit from postoperative pain management education.
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