Acceso usuarios
Teresa Sanclemente, Sandra Ponce Ruiz, Consuelo Álvarez Lorenzo, Esperanza Zuriguel Pérez, Raquel Tapia Melenchon, Marc Ramentol, Maria del Mar Villar Casares, Jordi Teixidor Serra, V. Molero García, Judith Sánchez Raya, Mª Pilar Lalueza Broto, Àlex Ginés Puertas, Miriam Garrido Clua, Jaume Mestre Torres
Antecedentes y objetivo La fractura de fémur (FF) es una lesión frecuente en personas de edad avanzada. El objetivo fue evaluar la efectividad de una intervención educativa multidisciplinar en pacientes con FF para favorecer el regreso al domicilio y disminuir las complicaciones hospitalarias.
Material y método Estudio cuasiexperimental con medidas repetidas al ingreso, al alta, a los 30días y al año de seguimiento. Se incluyeron pacientes ≥65años con FF ingresados en la unidad de ortogeriatría entre febrero de 2016 y enero de 2017. La intervención educativa constó de dos actuaciones coordinadas: una educación sanitaria durante la hospitalización y un soporte multimodal durante la transición al domicilio.
Resultados Se incluyeron 67 pacientes (77,6% mujeres; edad 84,19±7,78 años). Regresaron al domicilio el 70,1%, doblando la cifra de los años 2014-2015. Hubo un 8,5% de reingresos a los 30días y al año. Al año, el nivel de dependencia fue cercano al nivel prefractura (Barthel: 86,67±19,31; 94,33±14,66), la movilidad mejoró respecto al alta (Parker: 4,73±1,84; 6,73±2,76; Timed Up and Go test: 38,29±21,27; 21,91±10,97) y el rendimiento cognitivo no empeoró de forma significativa. La percepción de pacientes, cuidadores y profesionales fue que la educación sanitaria mejoró la autonomía del paciente. La satisfacción con el proceso asistencial fue alta.
Conclusiones Este estudio aporta como novedad, a los beneficios ya descritos en los modelos asistenciales ortogeriátricos, el incremento del número de pacientes que regresan al domicilio en condiciones de seguridad.
Background and objective Hip fracture is a common injury among elderly patients. The main goal of our study was to assess the effectiveness of a multidisciplinary educational intervention aimed at hip fracture patients to promote home discharges and reduce in-hospital complications.
Material and method A quasi-experimental study was performed by taking repeated measurements at hospital admission, at hospital discharge, and at both 30days and one year of discharge. Patients aged ≥65years with hip fracture who were admitted to the Orthogeriatric Service between February 2016 and January 2017 were included in the study. The educational intervention consisted in two coordinated actions: patient education administered during their hospitalization and multimodal support provided during their discharge home.
Results A total of 67 patients were included in the study (77.6% of whom were women; 84.19±7,78 years old). Of these, 70.1% were discharged home, which doubles the figures recorded in the 2014-2015 period. The rate of readmission at 30days and one year of the discharge was 8.5%. At the one-year follow-up, the patient's dependence to perform basic activities of daily living was nearer to the pre-fracture level (Barthel: 86.67±19.31; 94.33±14.66), their mobility had improved in comparison with the time of discharge (Parker: 4.73±1.84; 6.73±2.76; Timed Up and Go Test: 38.29±21.27; 21.91±10.97), and their cognitive function had not worsened significantly. The patient education measures improved the patients’ autonomy as perceived by the patients, the caregivers, and the healthcare providers. Satisfaction with the healthcare received was high.
Conclusions As a novelty to the already described benefits in orthogeriatric care models, this study would contribute by proving an increase of the number of patients discharged home in a safe condition.
