Orthogeriatric Care in the Emergency and Perioperative Setting

This chapter explores the perioperative care of older people with significant fragility fractures requiring orthogeriatric care, with a focus on hip fracture as the most common of these injures. Surgery is the preferred treatment for most hip fractures. Perioperative care concerns the pre-, intra- and post-operative phase of the surgery. Principles of care and management include all fundamental aspects of care as well as specialised interventions for older people with a focus on prevention and recognition of complications.

The care of the orthogeriatric patient following hip fracture and subsequent surgery presents significant challenges for the healthcare team. Assessment and subsequent care are best provided by effective interdisciplinary team working based on sound orthogeriatric principles. Nurses are often not only the caregivers, but also the coordinators of that care, and need to understand different types of hip fracture and their management so that they can deliver evidence-based acute and perioperative care to patients based on each person’s specific needs.

Acquiring a hip fracture is experienced as a life-changing event with severe and frightening consequences for the individual. Although physical care attracts the most attention, patients’ existential worries and concerns must be considered as achieving good outcomes in rehabilitation after a hip fracture requires significant motivation and effort from the person.

The aim of this chapter is to outline the fundamental care principles across the three perioperative phases. Effective evidence-based nursing care is crucial in optimising patient outcomes following hip fracture. Even once the patient has recovered from surgery, there remains the need to comprehensively prepare them for discharge.