Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2929_Библиотеки_им_академика_М_И_Перельмана
.pdf
Perspectives in Nursing Management and Care for Older Adults
Series Editors: Julie Santy-Tomlinson · Paolo Falaschi · Karen Hertz
Karen Hertz
Julie Santy-Tomlinson Editors
Fragility Fracture
and Orthogeriatric
Nursing
Holistic Care and Management of the
Fragility Fracture and Orthogeriatric
Patient
Second Edition
Perspectives in Nursing Management
and Care for Older Adults
Series Editors
JulieSanty-Tomlinson, Odense University Hospitals
University of Southern Denmark
Odense,Denmark
PaoloFalaschi, Sant’Andrea Hospital
Sapienza University of Rome,Rome,Italy
KarenHertz, University Hospitals of North Midlands
Royal Stoke University Hospital,Stoke-on-Trent,Staffordshire,UK
The aim of this book series is to provide a comprehensive guide to nursing
management and care for older adults, addressing specic problems in nursing and
allied health professions. It provides a unique resource for nurses, enabling them to
provide high-quality care for older adults in all care settings. The respective volumes
are designed to provide practitioners with highly accessible information on
evidence-based management and care for older adults, with a focus on practical
guidance and advice.
Though demographic trends in developed countries are sometimes assumed to be
limited to said countries, it is clear that similar issues are now affecting rapidly
developing countries in Asia and South America. As such, the series will not only
benet nurses working in Europe, North America, Australasia and many developed
countries, but also elsewhere. Offering seminal texts for nurses working with older
adults in both inpatient and outpatient settings, it will especially support them
during the rst ve years after nurse registration, as they move towards specialist
and advanced practice.
The series will also be of value to student nurses, employing a highly accessible
style suitable for a broader readership.
Karen Hertz • Julie Santy-Tomlinson
Editors
Fragility Fracture and
Orthogeriatric Nursing
Holistic Care andManagement
oftheFragility Fracture
andOrthogeriatric Patient
Second Edition
Editors
https://t.me/medicina_free
Karen Hertz
University Hospitals of North Midlands
Royal Stoke University Hospital
Stoke-on-Trent, Staffordshire, UK
Julie Santy-Tomlinson
Odense University Hospitals
University of Southern Denmark
Odense, Denmark
ISSN 2522-8838 ISSN 2522-8846 (electronic)
ISBN 978-3-031-33483-2 ISBN 978-3-031-33484-9 (eBook)
https://doi.org/10.1007/978-3-031-33484-9
Fragility Fracture Nework
© The Editor(s) (if applicable) and The Author(s) 2018, 2024.
Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
original author(s) and the source, provide a link to the Creative Commons license and indicate if changes
were made.
The images or other third party material in this book are included in the book's Creative Commons
license, unless indicated otherwise in a credit line to the material. If material is not included in the book's
Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the
permitted use, you will need to obtain permission directly from the copyright holder.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable.
This book is an open access publication.
Foreword
https://t.me/medicina_free
The rst edition of this book [1] was a sister to another publication ‘Orthogeriatrics’
[2], which laid out the principles of management of older patients with fragility
fractures, along so-called ‘orthogeriatric’ lines, and was aimed at all the relevant
healthcare professionals who might be involved in orthogeriatric care and management. Although the latter publication included a chapter on the nursing role, it was
clear that the centrality of nurses in optimising patient care in the orthogeriatric
setting warranted a much more detailed exposition. This was produced by an enthusiastic team, in which the editors and all the authors were practising nurses. So far,
that edition has had almost a quarter of a million chapter downloads from a wide
range of countries, demonstrating the growing awareness of the challenge of fragility fractures and the key role of nurses in rising to it.
Both publications were driven and supported by the Fragility Fracture Network
(in particular, its Education Committee), a global organisation that aims to ‘… opti-
mise globally the multidisciplinary management of the patient with a fragility fracture including secondary prevention’ (www.fragilityfracturenetwork.org).
In the intervening years, the FFN has grown and matured, with a strong contribution from the global nursing community, who constitute a large proportion of its
membership. There has been a substantial increase in the body of evidence supporting the efcacy and cost-effectiveness of orthogeriatric co-management in general,
and orthogeriatric nursing in particular. Furthermore, dissemination of the messages
in the rst edition of the nursing book, in a rich international series of events organised by the FFN Education Committee, has deepened our appreciation of the nurses’
role and our knowledge in how to develop it. It was therefore timely for both books
to be updated.
The second edition of the ‘Orthogeriatrics’ book [3] was laid out in conformity
with the four ‘pillars’ of orthogeriatric co-management that had been dened in the
intervening years:
1. Co-management of the acute fracture episode
2. Rehabilitation to regain function and independence
3. Secondary prevention (of further fractures)
4. Advocacy for policy change to enable the rst three
v
vi
https://t.me/medicina_free
Foreword
In addition, the book contains a section on ‘cross-cutting’ issues that applied
across all the pillars and, unsurprisingly, nursing was one of these.
This second edition of the Fragility Fracture Nursing book expands and enhances
the description of nurses’ contribution to optimising care and management for those
with fragility fractures. It now includes contributions from a global pool of experts
in the eld, as well as contributions from other members of the allied health team,
reecting the interdisciplinary nature of optimal fragility fracture care.
Orthogeriatric nursing and fragility fracture nursing are two facets of the same
coin—one focused on co-managed acute care of signicant fragility fractures such
as hip fracture and the other on the pathway of care that leads to prevention of future
fractures. The book is more comprehensive than its predecessor as it includes greater
depth of discussion of aspects of orthogeriatric and fragility fracture nursing such as
comprehensive geriatric assessment, fracture prevention, fall prevention, frailty
management, nutrition, rehabilitation, remobilisation and exercise, carer involvement and hospital discharge.
Orthogeriatric nursing and fragility fracture nursing are still developing their
theory, practice and evidence base. In some parts of the world, the nursing contribution has been enhanced by the development of advanced nurse practitioners in
orthogeriatrics. This has happened in acknowledgement that there are too few geriatricians to provide optimum care from an orthogeriatric perspective, and in some
parts of the world, there are no geriatricians at all. Recognising that nurses can
develop advanced skills in this area that can enhance and optimise the management
and care of older people with fragility fractures is an important rst step in this
journey for other countries where this model is championed by medical practitioners. Similarly, in some models of fracture prevention, nurses are leading the development of secondary prevention services.
Nurses are also beginning to develop their own theoretical perspective of what
constitutes orthogeriatric and fragility fracture nursing and articulating the role of
these in clinical practice. They are also increasingly engaged in and leading audit
and research that demonstrates the immense value of nursing in optimising patient
outcomes. This is enabling them to become empowered to develop their role, not
only in expert and advanced care provision, but also in coordinating the orthogeriatric and fragility fracture care team in situations where nursing is central.
It is our great hope and belief that empowerment of nurses through the knowledge encapsulated in this book will play a major role in driving positive change in
fragility fracture care in all countries of the world.
References
1. Hertz K, Santy-Tomlinson J (eds) (2018). Fragility fracture nursing: holistic care
and management of the orthogeriatric patient. Springer, Cham
2. Falaschi P, Marsh D (eds) (2017). Orthogeriatrics. Springer, Cham, https://link.
springer.com/book/10.1007/978- 3- 319- 76681- 2
Foreword
https://t.me/medicina_free
vii
3. Falaschi P, Marsh D (eds) (2021). Orthogeriatrics: the management of older
patients with fragility fractures, 2nd edn. Springer, Cham, https://link.springer.
com/book/10.1007/978- 3- 030- 48126- 1
Emeritus Professor of Orthopaedics DavidMarsh
University College London
London, UK
Sapienza University of Rome PaoloFalaschi,
Roma, RM, Italy
Preface to the Second Edition
https://t.me/medicina_free
Since the rst edition of this book was published in 2017, many things have changed
while many others have stayed the same. Patients with fragility fractures remain the
most common orthopaedic trauma inpatients in every acute hospital in almost every
country. In many countries, the incidence has continued to increase, while in a few
countries, the rise in incidence appears to be peaking but remains unacceptably high.
Patients who have sustained a fragility fracture are still usually elderly, although
their average age may have increased alongside global population ageing. And they
are also often frail—especially those who have suffered a signicant fragility fracture requiring hospitalisation such as a hip fracture. These are injuries which nearly
always require major orthopaedic surgery, engendering signicant physiological
and psychological stress and leading to signicant reduction in individual function
and mobility; loss of independence; physical, cognitive and psychological complications; and death. The need for a new edition of this book is, therefore, as acute as
it ever was, if not more so.
This second edition has been written during the third year of the COVID-19
pandemic, which began in 2020, at a time during which there have been many
unavoidable changes in numerous aspects of life. Many older people have had to
change the way they live—spending more time at home, and more time alone as
they have attempted to protect themselves from community spread of the virus. The
impact of this on their health and well-being has not yet been extensively studied. It
is very likely, however, that this has resulted in a cohort of older people whose musculoskeletal system has been deconditioned by periods of limited activity and who
have become more reluctant to socialise within their communities. This places them
at greater risk of both falls and osteoporosis—and, therefore, fragility fractures.
Many health services are beginning to recognise the unique needs of this group
of often frail and vulnerable patients and are developing orthogeriatric services and
‘enhanced care’ units (often known as orthogeriatric units or hip fracture wards/
units) where there is access to specialist medical, nursing and therapy care that
includes geriatricians and other members of a multidisciplinary team with advanced
skills in managing patients with highly complex needs following a fracture.
This edition has been written by a team of global expert practitioners in fragility
fracture care, while the last edition was largely focused on the European experience.
This reects the increasing networking among fragility fracture practitioners facilitated by the Fragility Fracture Network (FFN) (www.fragiltiyfracturenetwork.org).
ix
x
https://t.me/medicina_free
Preface to the Second Edition
This has led to increased opportunities for knowledge and skill sharing internationally so that care at every stage of the pathway can be optimised. Patients whose care
and management are not optimised have very poor outcomes in terms of regaining
functional abilities, and they experience prolonged pain and complications that can,
ultimately, lead to death.
Evidence-based, interdisciplinary care involves blending of the skills brought to
the team by a diverse group of clinicians. This new edition reects this through the
involvement of many new authors from various professional backgrounds such as
nursing, physiotherapy, nutrition, rehabilitation, medicine and surgery and crossing
the speciality boundaries of orthopaedics, geriatrics, bone health and
rehabilitation.
Patients with fragility fractures also need skilled and professional care in community and outpatient settings with a particular focus on bone health and fracture
prevention. This reects the ethos of the FFN, an organisation aimed at optimising
globally ‘... the multidisciplinary management of the patient with a fragility frac-
ture, including secondary prevention’.
The wealth of fragility fracture/orthogeriatric knowledge presented in this book
is accessible to all practitioners who provide fragility fracture care in any setting
and, it is hoped, will be available to the next generation of practitioners who want to
practice in this challenging eld and continue to improve and optimise care. This
knowledge comes from the growing evidence base that informs best practice, as
well as the diverse and extensive experience of the contributors.
The chapters provide a comprehensive exploration of the four ‘Fs’ of fragility
fracture care:
• Fragility
• Fracture
• Falls
• Frailty
As well as an overview of three of the FFN’s pillars of fragility fracture care
clinical intervention:
• Acute care
• Rehabilitation
• Fracture prevention
This is a complementary book to Orthogeriatrics edited by Falaschi and Marsh
[1]. An unrestricted educational grant from the industry partner, UCB, has enabled
the book to be published online as an open-access eBook so that the education it
offers is freely available to all practitioners across the globe, no matter what their
location or income. This support has been freely offered because education generates the power to make the care of patients with fragility fractures the very best
it can be.
Соседние файлы в папке Библиотека им академика М.И. Перельмана