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Our 77-year-old mother is in the hospital with a broken leg. She had surgery late last night (Friday) and now nursing staff is waiting for the physical therapist to get her up and walking. The surgeon says he wants her up as soon as possible after the surgery to reduce complications. And she's supposed to be walking with a walker and medical staff everyday. But the therapist is only here this morning and there's reduced nursing coverage (and no therapist) tomorrow. If they have these policies in place, why don't they carry them out? I'm frustrated!
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Your mother's surgeon is right on with the orders to get her up and moving. Studies show that early ambulation after surgery for hip fracture can reduce complications and the costs associated with those complications. With this approach, more patients are able to go directly home from the hospital. More complications and longer hospitalizations increase the risk of discharge to a secondary unit such as a step-down/transition unit, extended care facility, or nursing home.
Although this information has been reported in the literature, immediate weight-bearing has not become a universally accepted and practiced treatment approach. A recent study from Italy showed that reduced numbers of physical therapists and nurses and the absence of physicians in the hospitals on weekends and holidays appear to make a difference in how patients progress after surgical stabilization of hip fractures. Patients who were operated on right before the weekend (e.g., on Friday) or before a holiday were more likely to experience a delay before getting up and going.
The authors suggest that if, as they showed in their study, the model of care for early in-hospital rehab of older adults with hip fractures can reduce the time of functional recovery, then results (especially long-term results) should be explored further. Data of this type may help move more hospitals toward a pattern of earlier recovery through immediate weight-bearing. If the center where your mother is currently hospitalized has already adopted an immediate weight-bearing protocol, then they should be creating staffing patterns to follow up on the program.
It's possible your facility normally does have adequate staffing and you happened to hit it at a time when there were some specific staffing problems. You can always check with nursing to see if that's the case. You may want to contact the administrative staff (probably on Monday) and let them know of your frustration. It may not help your mother's immediate needs, but it could be the catalyst that helps bring about improved care for others who will face this same problem in the future.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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