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New NICE hip fracture guidelines

New NICE hip fracture guidelines

A public consultation on draft guidelines for the management of hip fracture in adults has been opened by the National Institute for Health and Clinical Excellence (NICE).

The type of NHS treatment and care that should be given to people who have suffered a hip fracture is outlined in the draft guide. It covers from the time a patient is admitted, to when they are sent home, as well as their final discharge and follow-up care.

Dr Fergus Macbeth, NICE Clinical Practice Centre Director, said: "Evidence indicates that there is considerable variation in clinical practice, which can affect the quality of care that hip fracture patients of all ages receive. For example, prompt surgery has been generally recognised as important, but it's sometimes delayed for administrative or clinical reasons."

Any comments on the draft guideline from registered stakeholders can be made through the NICE website. The deadline for the consultation period closes on 12 January 2011.

Draft recommendations for consultation include:

Timing of surgery: Offer patients who require surgery an operation to be carried out on the day of, or the day after, admission, and identify and treat specified correctable co-morbidities immediately so that surgery is not delayed.

Surgical procedures: recommendations on when to offer arthroplasty (joint reconstruction or realignment) and total hip replacements depending on the specific type of hip fracture and patient's individual circumstances.

Mobilisation strategies: Offer patients physiotherapy assessment and, unless medically or surgically contraindicated, mobilisation on the day after surgery, and offer patients mobilisation at least once a day and ensure regular physiotherapy review.

Multidisciplinary management: From admission, offer all hip fracture patients a formal, acute orthogeriatric or orthopaedic ward-based Hip Fracture Programme that incorporates aspects including:

Early identification of individual goals for multidisciplinary rehabilitation to help patients regain their mobility and independence as quickly as possible,

Continued regular orthogeriatric and multidisciplinary review,

Continued regular orthogeriatric (joint orthopaedic and geriatric care service) and multidisciplinary review comprehensive information exchange with the patient's primary care team.

Copyright © Press Association 2010

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