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Introduction <p>Fragility hip fractures (HF) in older adults are associated with substantial morbidity, mortality, and functional decline. In Spain, evidence regarding the contribution of orthogeriatric nursing (OGN) roles within multidisciplinary teams remains limited. This study evaluated clinical outcomes associated with the implementation of an orthogeriatric nurse within a hip fracture clinical care pathway.</p> Methods <p>A retrospective cohort study was conducted including patients aged ≥ 75&#xa0;years admitted with fragility hip fracture between 2017–2019 (pre-OGN period) and 2022–2023 (post-OGN period) at the Rey Juan Carlos University Hospital. Patients managed outside the clinical pathway or not undergoing surgical treatment were excluded. The primary outcome was the occurrence of grade II or higher-pressure ulcers, acute confusional syndrome, or prolonged immobility, defined as absence of out-of-bed mobilisation within the first 24 postoperative hours.</p> Results <p>A total of 776 patients (mean age: 87&#xa0;years; 78% women) were analyzed. Implementation of the OGN was associated with a lower occurrence of the composite outcome (59.8% vs 47.2%; unadjusted OR 0.60, 95% CI 0.45–0.80) largely reflecting lower rates of prolonged immobility (30.2% vs 13.1%; <i>p</i> &lt; 0.001). After adjustment for confounders, the effect remained statistically significant (adjusted OR 0.56, 95% CI 0.42–0.76), The median hospital stay was also reduced (10 vs 7&#xa0;days; <i>p</i> &lt; 0.001) and a non-significant trend towards lower in-hospital mortality was observed (5.4% vs 3.1%; <i>p</i> = 0.109).</p> Conclusion <p>Implementation of an orthogeriatric nurse within the hip fracture clinical pathway was associated with improved in-hospital outcomes and a shorter hospital stay. Causal relationships cannot be inferred due to the observational design.</p>

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Clinical impact of implementing an orthogeriatric nurse in the care pathway for elderly patients with hip fragility fractures

  • 期刊论文

  • 发表日期：

    2026年3月27日

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  • Clara Valverde Fontcuberta,
  • Verónica García Cárdenas,
  • Cristina González de Villaumbrosia,
  • David Sáez Martínez,
  • José Antonio Rueda-Camino

摘要

Introduction

Fragility hip fractures (HF) in older adults are associated with substantial morbidity, mortality, and functional decline. In Spain, evidence regarding the contribution of orthogeriatric nursing (OGN) roles within multidisciplinary teams remains limited. This study evaluated clinical outcomes associated with the implementation of an orthogeriatric nurse within a hip fracture clinical care pathway.

Methods

A retrospective cohort study was conducted including patients aged ≥ 75 years admitted with fragility hip fracture between 2017–2019 (pre-OGN period) and 2022–2023 (post-OGN period) at the Rey Juan Carlos University Hospital. Patients managed outside the clinical pathway or not undergoing surgical treatment were excluded. The primary outcome was the occurrence of grade II or higher-pressure ulcers, acute confusional syndrome, or prolonged immobility, defined as absence of out-of-bed mobilisation within the first 24 postoperative hours.

Results

A total of 776 patients (mean age: 87 years; 78% women) were analyzed. Implementation of the OGN was associated with a lower occurrence of the composite outcome (59.8% vs 47.2%; unadjusted OR 0.60, 95% CI 0.45–0.80) largely reflecting lower rates of prolonged immobility (30.2% vs 13.1%; p < 0.001). After adjustment for confounders, the effect remained statistically significant (adjusted OR 0.56, 95% CI 0.42–0.76), The median hospital stay was also reduced (10 vs 7 days; p < 0.001) and a non-significant trend towards lower in-hospital mortality was observed (5.4% vs 3.1%; p = 0.109).

Conclusion

Implementation of an orthogeriatric nurse within the hip fracture clinical pathway was associated with improved in-hospital outcomes and a shorter hospital stay. Causal relationships cannot be inferred due to the observational design.