I manage a general med/surg was that has some (mostly geriatric) orthopedics. We often have fractured hip patients who stay pre op for at least 24 hours prior to going to OR for repair. We just had a fractured hip patient who was scheduled for a bipolar prothesis as a repair since his fracture broke the femoral head. Several of my nurses moved him (with his hip splinted) from the bed to a gurney on a slide board and the OR supervisor insists that we violated a common standard of care that you never move a fractured hip. Our Nurse practitioners who cover these patients disagree and believe that the patients need to be moved to prevent numerous complications (i.e. dvt's, pneumonia). I understand that you would certainly stablilze a fracture by splinting but we move patients from bed to gurney to take to Xray, CAT scan and we turn them Q2 while in bed. Is there anyone that can tell me what you do, as this had gone to the Chief Nurse who wants me to look for references and standards to support our practice. Help! :uhoh21:
Jun 10, '04
.....Preoperative traction has no value in relieving pain. (9) It has been claimed to reduce the risk of further fracture displacement occurring, but this remains unproven. The injured leg should always be treated with care as further movements of the joint may jeopardise the precarious blood supply to the femoral head.
For an undisplaced intracapsular fracture, delay from fracture to surgery will not influence the risk of fracture healing complications, other than for the risk of the fracture becoming displaced. Surgery, therefore, is recommended as soon as the patient is appropriately prepared, but need not be out of hours. For displaced intracapsular fractures there is contradictory evidence regarding the timing of surgery. Limited evidence suggests that surgery must be performed as soon as possible after injury to reduce the risk of fracture healing complications.(10) Other studies indicate that a delay of up to a week have no effect on fracture healing but after that time the risk of nonunion is markedly increased.(11,12)
You may want to look into the National Association of Orthopaedic Nurses publication the Core Curriculum
Your library may be able to get it for you. In it you will find almost everything you need to know about ortho.
Good luck with convincing your colleague in the OR that she is WRONG.
Last edit by P_RN on Jun 12, '04
: Reason: quote contained irrelevant information