Quality statements - Hip Fracture Clinical Care Standard

A patient presenting to hospital with a suspected hip fracture receives care guided by timely assessment and management of medical conditions, including cognition, pain, nutritional status and frailty. Arrangements are made according to a locally endorsed hip fracture pathway.

Find out what this means for Consumers, Clinicians and Healthcare Services

A patient with a hip fracture is assessed for pain at the time of presentation to the emergency department and regularly throughout their acute admission. Pain management includes appropriate multimodal analgesia, and incorporates peripheral nerve blocks unless contraindicated.

A patient with a hip fracture is offered treatment based on an orthogeriatric model of care as defined in the Australian and New Zealand Guideline for Hip Fracture Care. Coordinated orthogeriatric and multidisciplinary review includes assessment and management of malnutrition, frailty, cognitive impairment and delirium.

A patient with a hip fracture receives surgery within 36 hours of first presentation to hospital.

A patient with a hip fracture is mobilised without restrictions on weight bearing starting the day of, or the day after surgery, and at least once a day, according to the patient’s clinical condition and agreed goals of care. Includes practical advice to maximise function, and limit the impact of pain and other symptoms on daily life. The plan addresses individual needs and preferences.

Before a patient leaves hospital after a hip fracture, they receive a falls and bone health assessment and management plan, with appropriate referral for secondary fracture prevention.

Before leaving hospital, an individualised care plan is developed in discussion with the patient and their family or support person, that describes their goals of care and ongoing care needs. The plan includes mobilisation activities and expected function post-injury, wound care, pain management, nutrition, fracture prevention strategies, changed or new medicines and specific rehabilitation services and equipment. This plan is provided to the patient, and communicated with the patient’s general practice and other ongoing clinicians and care providers on discharge.