An evidence-based proposal: implementing a suspected neck of femur fracture care bundle in prehospital care

Stinger, Lucy (2024) An evidence-based proposal: implementing a suspected neck of femur fracture care bundle in prehospital care. Masters dissertation, University of Cumbria. Item availability may be restricted.

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Abstract

There is an ever-increasing incidence of NOF fractures in elderly people requiring transportation to the hospital via the ambulance service due to the injury often immobilising patients. Within prehospital care, there is a lack of standardised care for suspected neck of femur patients, national and local guidelines focus on the need for pain relief to be administered prehospitally. Despite this, there is a lack of pain relief provided prehospitally and little consideration for other aspects of care for these patients. This evidence-based proposal for change explored in this dissertation aims to implement a care bundle for suspected neck of femur fracture patients prehospitally. This care bundle will aim to provide pain relief, immobilise the injury, provide intravenous fluids and alert the receiving hospital to the patient’s condition. This care bundle aims to work with the hospital's fast-track system to reduce the time to surgery for these patients and in turn, has the potential to reduce the length of hospital stay and improve the patient's morbidity and mortality post-fracture. A literature review was undertaken of relevant guidelines and current literature to determine if the care bundle guidelines are current and evidence-based. This project represents a complex clinical change initiative within the ambulance service. In this project, Kotter’s eight-step model (1996) was applied with the use of change management tools to aid the change and evaluation strategy taken. This work undertaken will be presented to a local ambulance service’s senior clinical management for consideration of implementing the neck of femur care bundle prehospitally to improve patient outcomes.

Item Type:	Thesis/Dissertation (Masters)
Departments:	Institute of Health > Continuing Development and Health Leadership
Additional Information:	Dissertation submitted in part fulfilment for the MSc Paramedic: Practice Development, University of Cumbria, July 2024, word count 13,750.
Depositing User:	Anna Lupton
Date Deposited:	03 Dec 2024 12:19
Last Modified:	12 Dec 2024 11:11
URI:	https://insight.cumbria.ac.uk/id/eprint/8527