What Are the Factors Contributing to the Delay in Hip Fracture Repair?

Hip fracture injuries are identified as one of the most serious healthcare problems affecting older adults (CDC). The prognosis after hip fracture is unfavorable and approximately 25% of elderly patients will die within one year after the event. Surgical repair is a critical element in the management of a hip fracture. Delay of surgery prolongs hospital stay and increases the risk of medical complications. Despite evidence showing early time to surgery reduces morbidity and mortality for patients with hip fractures, time delays to surgery still exist. The purpose of this quality improvement project was to explore patient- and hospital-specific barriers to early surgery for older adults with hip fractures in a community hospital. Kathleen Stevens’ ACE Star Model was used as a conceptual framework to guide this project. A retrospective chart review was conducted with a total of 62 charts consisting of 55 females and 8 males who experienced a hip fracture. Data collected included age, gender, time from emergency room arrival to admission, time from admission to operative intervention, current medications on admission, current use of tobacco and alcohol, type of surgical intervention, and length of stay. Average length of time from admission to surgery was 29 hours. Eight charts were identified with a delay of greater than 48 hours to surgery. Patient-specific barriers were identified. Further research is indicated to determine hospital-specific barriers to early surgery