Hipcast: Recent Episodes
Australia & New Zealand Hip Fracture Registry
On this episode, A/Prof Jennifer Stevens and Emma Pauley share findings from their quality improvement project titled: A post-operative analgesic bundle of fascia iliaca catheter and celecoxib for elderly patients with hip fracture: a quality improvement project.
Jenny is an Associate Professor at both University of Notre Dame and UNSW as well as an anaesthetist and pain specialist at St Vincent’s Campus in Sydney, Australia. Emma is a Senior Orthopaedic Physiotherapist, also at St Vincent’s Hospital Darlinghurst.
Please find below the links for the resources mentioned in this episode:
- ANZCA Resources for Change: https://www.anzca.edu.au/getContentAsset/4e02b985-9852-426f-aa16-b7f06ac2725a/80feb437-d24d-46b8-a858-4a2a28b9b970/Celecoxib-guidelines-May-2024.pdf?language=en
- Gawthorne J, Stevens J, Faux S, Leung J, McInnes E, Fasugba O, Mcelduff B, Middleton S. Can emergency nurses safely and effectively insert fascia iliaca blocks in patients with a fractured neck of femur? A prospective cohort study in an Australian emergency department. Journal of Clinical Nursing. 9th June 2021. https://doi.org/10.1111/jocn.15883
- Riley M, Tassie B, Gawthorne J, Hadzic R, Stevens J. Increased opioid consumption following regional nerve blockade: could fascia iliaca block be associated with rebound pain in neck of femur fracture? Br J Anaes. 10 May 2021. https://doi.org/10.1016/j.bja.2021.03.034
On the episode, the Older Persons Emergency Network (OPEN) Clinical Director Dr Elizabeth (EJ) Marsden and OPEN nurse practitioner Sarah Bold share their teams achievements to provide pre-hospital hip fracture care. The OPEN Metro North team provides a pre-hospital neck of femur fracture pathway as a Queensland Ambulance Service co-response emergency department substitution model to provide timely outreach care for frail older persons living in residential aged care facilities and the community.
Joining us on this episode to revisit and update on the topic of direct oral anticoagulants, or DOACS, and timing of surgery are Dr Hannah Seymour, a consultant geriatrician from Fiona Stanley Hospital in WA and Dr Seth Tarrant an orthopaedic surgeon from John Hunter Hospital NSW.
We covered this topic on this Hipcast episode in 2024 with Hannah and Professor Rebecca Mitchell following the results of ANZHFR Sprint Audit and publication of the Fragility Fracture Networks’ consensus statement in the journal Anaesthesia. We will also be looking at how time to surgery is tracking across AU and NZ and implications of this for practice.
Dr Suzanne Dyer presents on What the Evidence Tells Us in Rehabilitation at the ANZHFR Hipfest 2023. Dr Dyer is a senior research fellow at Flinders University, she’s worked as a researcher in both the public and private sector with expertise in evidence based methodologies including health technology assessment, systematic reviews, meta-analysis and guideline development. She’s the author of over 70 publications and reports including the Cochrane Review on Interventions for Improving Mobility after Hip Fracture.
Please find the mentioned research below:
- Interventions for improving mobility after hip fracture surgery in adults - 2022 Cochrane Review
- Multidisciplinary rehabilitation for older people with hip fractures - 2021 Cochrane Review
- Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery - 2015 Cochrane Review
Joining the John Hunter Hospital hip fracture care team on Hipcast to sharing their insights into the multidisciplinary care approach of their site awarded the ANZHFR Australian Golden Hip 2023 Award for top performing hospital.
Joining us on the episode:
- Mrs Ramya Kunnath: Orthopaedic Clinical Nurse Consultant - Hunter New England LHD
- Dr Erica Epstein: Geriatrician - Hunter New England LHD
- Dr Seth Tarrant: Orthopaedic surgeon - Hunter New England LHD
- Prof Zsolt Balogh: Director of Trauma - Hunter New England LHD
Professor Kim Delbaere & Dr Rik Dawson share their work on raising awareness for falls prevention nationally.
Kim is a Senior Principal Research Scientist at Neuroscience Research Australia and a Professor of Health Sciences at the University of New South Wales. She is the current President of the Australian and New Zealand Falls Prevention Society.
Dr Rik Dawson is a Gerontological Physiotherapist and postdoctoral researcher at the Institute for Musculoskeletal Health at the University of Sydney. Rik is the current National President of the Australian Physiotherapy Association.
A/Prof Danielle Ni Chroinin explores the effect of a multidisciplinary care bundle on the incidence of delirium after hip fracture surgery.
Links discussed:
1. The effect of a multidisciplinary care bundle on the incidence of delirium after hip fracture surgery: a quality improvement study (2020) in Anaesthesia
2. Delirium Reduction by Analgesia Management in Hip Fracture surgery (DRAM-HF): Exploration of perceived facilitators and barriers (2021) in Australasian Journal on Ageing
3. Clinical Practice Guideline: Orthogeriatric Hip Fracture Care (2023)
1 in 3 Australians aged 65 and over fall each year making it the leading cause of death for this age group.
Rik Dawson, an experienced physiotherapy and researcher, lifts the curtain to explain what is happening in residential care facilities in terms of physiotherapy care and rehabilitation and explores some important issues including:
- The lack of rehabilitation available in residential aged care facilities;
- The massive problem of falls in these facilities;
- The challenges of providing care and staffing as set by the Aged Care Act 1997 and the impact on coordinated care;
- Specific areas of focus in physiotherapy and residential aged care that warrant funding for improved quality of life outcomes.
Coming to you live at the 2024 ANZHFR Hipfest in Sydney to hear about how the Registry data is fuelling improvements in hip fracture care across the country.
Guests include:
- Dr Sheila Rahman, Orthogeriatrician, Campbelltown Hospital (NSW)
- Dr Hannah Seymour, Geriatrician, Fiona Stanley Hospital (WA)
- Mel Alexander, Intensive Care Paramedic, SA Ambulance Service (SA)
Dr Lara Harvey, a senior research fellow at Neuroscience Research Australia and our ANZHFR co-chair Prof Jacqueline Close, a geriatrician based at Prince of Wales Sydney discuss their newly published research titled “Adherence to clinical care standards and mortality after hip fracture surgery in New South Wales, 2015–2018: a retrospective population-based study”.
The ACSQHC hip fracture care clinical care standard comprises seven quality statements supported by 16 quality indicators. This study looked at the impact of adherence to these standards on mortality for patients with hip fracture.
You can find the full study here in the Medical Journal of Australia.
In this episode, Professor Rebecca Mitchell and Dr Hannah Seymour discuss the work they led in partnership with international colleagues from the Fragility Fracture Network on consensus statements developed to aid clinicians in their decision-making and to reduce practice variations in the management of patients with hip fracture taking direct oral anticoagulants.
For the full article:
Principles for management of hip fracture for older adults taking direct oral anticoagulants: an international consensus statement
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16226?af=R
For more information on the upcoming ANZHFR Sprint Audit, email j.hallen@neura.edu.au
Professor Jacqui Close, Registry Co-Chair and Geriatrician at Prince of Wales Hospital, along with Dr Phil Black, Anaesthetist at Prince of Wales Hospital share the results of the ANZHFR Preoperative Fasting Sprint Audit and the implementation of Sip Til Send at Prince of Wales.
Resources:
Kluger MT, Culwick MD, Moore MR, Merry AF. Aspiration during anaesthesia in the first 4000 incidents reported to webAIRS. Anaesthesia and Intensive Care. 2019;47(5):442-451. doi:10.1177/0310057X19854456
The video recording of Professor Close's presentation on the Preoperative fasting sprint audit at the Binational Hip Fest can be found at: https://www.youtube.com/watch?v=Y1kadcg2Hz4
The podcast with Dr Matthew Checketts, Consultant Anaesthetist, titled Sip Til Send can be found at: https://hipcast.buzzsprout.com/1739857/10350612
For further information on the Sprint Audit, go to: https://anzhfr.org/sprintaudits/
Sip Til Send Resources: Prince of Wales and Sydney/Sydney Eye Hospital. See Shared hospital resources at https://anzhfr.org/resources/
Professor Xavier Griffin spearheads academic orthopaedics at Queen Mary University London and Barts Health, having joined as the inaugural chair of Bone & Joint Health. Professor Griffin's vision is for world class excellence in research and clinical academic training; providing opportunity for the next generation of clinician scientists to realise their aspirations.
Professor Griffin presented at ANZHFR's 2022 Binational Hip Festival in Melbourne, Australia on quality of life after hip fracture. We are pleased to provide his presentation in podcast format.
The open access publication mentioned early in the podcast can be found at:
https://boneandjoint.org.uk/article/10.1302/0301-620X.103B5.BJJ-2020-1839.R1
(Reference: Griffin XL, Achten J, Parsons N, Costa ML, On behalf of the WHiTE collaborators. Does performance-based remuneration improve outcomes in the treatment of hip fracture?. Bone Joint J. 2021;103-B(5):881-887. doi:10.1302/0301-620X.103B5.BJJ-2020-1839.R1)
The video recording of the presentation can be found at: https://www.youtube.com/watch?v=dLdbb-RnYgk
All recorded sessions from the ANZHFR 2022 Binational Hip Fest are available on our website: https://anzhfr.org/hipfest2022/
On this episode, join episode host James Wright, Registered Nurse and ANZHFR Project Manager, and guest Nicola Ward, NZ Hip Fracture Registry Coordinator and Clinical Nurse Specialist for the Fracture Liaison Service at Tauranga Hospital, NZ to hear some nursing tips for caring for people after hip fracture.
Dr Richard Kjar, Director of Orthopaedics, Ms Lisa Gephart, Clinical Nurse Consultant Acute Pain Service and Ms Megan Gilbert, Hip Fracture Clinical Specialist discuss the journey to implement the ANZHFR at Northeast Health Wangaratta in Victoria, Australia.
View the hospital's innovative NHW Hip Fracture Pathway - Staff awareness - Tik Tok type reel
Caroline Miller is a Consumer Representative on the New Zealand Implementation Committee of the Hip Fracture Registry.
Caroline has a lived experience of hip fracture and spoke at New Zealand's Hip Festival in Wellington in September 2022. Tune in to hear her advice to health professionals working in hip fracture care.
On this episode, join physiotherapist and ANZHFR project officer Karen Lee, Professor Cathie Sherrington from The University of Sydney, and physiotherapists Mr Brett Baxter from Princess Alexandra Hospital, Brisbane and Ms Rebecca Ferrier from The Prince Charles Hospital, Brisbane as they share their Hip Tips from Physiotherapy.
To summarise for our listeners, the Top Tips for Physiotherapy are:
-
Physiotherapy intervention early and as intense as possible.
-
Coordinated care is best. Look for opportunities to mobilise your patients
-
Enhance hip fracture recovery after discharge from hospital
-
Take care with progressing patients with hemiarthroplasty fixation performed via a lateral approach
-
The latest evidence tells us physio expertise is valuable after hip fracture including in the post-discharge phase
Recommended Resources:
-
https://australian.physio/inmotion/physiotherapy-and-fractured-neck-femur
-
Cochrane Review coming soon
-
Hip4Hips RCT
-
BOOST Study
-
ANZHFR Acute Rehabilitation Sprint Audit
Please contact Ms Rebecca Ferrier via rebecca.ferrier@health.qld.gov.au to find out more about The Prince Charles Hospital physio led hip fracture post-surgical review clinic.
This podcast episode is hosted for the ANZHFR by former Registry Manager, Elizabeth Armstrong. On this episode, Elizabeth discusses with Dr Irewin Tabu the development and implementation of the Multicenter Implementation of Orthogeriatrics and a Fracture Liaison Service for Older People who have sustained a Hip Fracture.
Dr Irewin Tabu is a Consultant in the Department of Orthopaedics at the University of the Philippines - Philippine General Hospital in Manila, and is Lead Investigator for the project which kicked off on the 1st April this year.
The project launch meeting can be found at: https://www.ffnphil.org/frameworkforasustainabledigitalhealthregistry
The APFFA Hip Fracture Registry toolbox can be found at https://apfracturealliance.org/hfr-toolbox/
REDCap is a secure web application for building and managing online surveys and databases. For more information go to https://www.project-redcap.org/
Join dietetics Dr Jack Bell from The Prince Charles Hospital, Kathryn Kane from Christchurch Hospital and Alexandra Fuller from The Wollongong Hospital as they share their top tips on optimising nutrition care of hip fracture using the SIMPLER approach.
Do you know what it’s like to undergo hip replacement surgery? James Wright, a registered nurse at the ANZHFR discusses the consumer experience of hip fracture replacement surgery patient and clinician Kristina Stiles.
Join registered nurse from ANZHFR James Wright as he hears about the acute journey of the hip fracture patient through the perspective of a loved one. Daughter Miranda Smith shares her recent lived experience of caring for her dad Barry's experience with hip fracture recovery.
This podcast episode is hosted by the Co-Chair of the Asia Pacific Fragility Fracture Alliance, geriatrician Dr Hannah Seymour from Fiona Stanley Hospital in WA. On this episode, Dr Seymour discusses the Hip Attack Trials with principal investigator Dr Flavia Borges. Dr Borges is an Internist and Assistant Professor in the Department of Medicine, and in the Perioperative Care Division at McMaster University. She is also an Investigator at the Population Health Research Institute, Hamilton, Canada.
On this Hip Tips episode, join ANZHFR co-chair and orthopaedic surgeon Dr Catherine McDougall and orthopaedic surgeons Dr Chris Wall Toowoomba Base Hospital & Dr Ruth Varrall from Rockhampton Base Hospital as they share their top tips for optimising care for patients with hip fracture from an orthopaedic perspective.
Recommended Resources:
1. Toowoomba Base Hospital: Rural NOF Pathway
2. The Health Investigators: Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture
3. AOANJRR: Hip Knee & Shoulder Arthroplasty Annual Report 2021
4. British Orthopaedic Association (not Hip Society): Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture
5. Fernandez et al, NEJM: Cemented or Uncemented Hemiarthroplasty for Intracapsular Hip Fracture
On this episode is Dr Mitchell Sarkies, a NHMRC Emerging Leadership Fellow from the Institute of Health Innovation at Macquarie University shares the upcoming plans for the ANZHFR Sprint Audit in acute rehabilitation.
Suggested references:
1. ANZHFR Sprint Audit page
2. Chartered Society of Physiotherapy: The national physiotherapy hip fracture sprint audit
3. ANZHFR March Newsletter
Please contact our Australian Registry Manager Jamie Hallen on j.hallen@neura.edu.au if your site would like to take part in this ANZHFR Sprint Audit.
Please note that due to the QLD Public Health Act requirement, QLD-based hospitals are not able to participate in the patient-level audit.
Welcome to our new Hipcast series "Hip Tips" providing you with tips from experts in hip fracture care.
On the episode, join ANZHFR co-chair and orthogeriatrician Prof Jacqueline Close & geriatrician Dr Sarah Hurring as they share their top tips for optimising care for patients with hip fracture from a geriatrics perspective.
Please see below for the list of resources mentioned:
1. ANZHFR Annual Report 2021
2. ANZHFR Sprint Audit summary page
3. ANZHFR Bone Protection Medication Sprint Audit
4. ANZHFR Nutrition Sprint Audit
5. Association of Anaesthetists of Great Britain & Ireland: Guideline for the management of hip fractures 2020
6. Hipcast: Sip Til Send with anaesthetist Dr Matthew Checketts (NHS, Scotland)
On today’s episode, we will be talking about the "Boost Project" with senior physiotherapist Marie March from Blacktown & Mt Druitt Hospitals in the Western Sydney Local Health District. Marie is a current clinical lecturer, PhD student, researcher and casual academic at the University of Sydney. She is also the chief investigator for the "Boost Project" investigating how hospitals can deliver more frequent exercise programs for inpatients with hip fracture through an implementation science study with physiotherapists and other healthcare workers.
Recommended resources:
- Hipcast: High Intensity Physiotherapy for Hip Fractures
- HIP4Hips (High Intensity Physiotherapy for Hip fractures in the acute hospital setting): a randomised controlled trial
- Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda
- Sax Translational Research Framework
In this, episode, consultant anaesthetic Dr Matthew Checketts from Ninewells Hospital Dundee, Scotland joins to share the initiative he’s been pioneering called the Sip Til Send policy which aims to reduce fluid fasting times for surgical patients in hospital. Anaesthetist and intensivist Dr Sean McManus from the Royal Brisbane and Women's hospital in Queensland also joins to discuss the clinical potential of this approach.
For those seeking advice on implementing this policy, you can contact Dr Checketts on Matthew.Checketts@nhs.scot
To access the Sip Til Send graphic, please click here.
On this episode anaesthetist A/Prof Mark Neuman of the REGAIN trial from the University of Pennsylvania joins to discuss the recently published Spinal Anesthesia or General Anesthesia for Hip Surgery in Older Adults in the New England Journal of Medicine. Geriatrician Dr Hannah Seymour from Fiona Stanley Hospital joins to discuss clinical impact of anaesthetic choice on the outcome of patients with hip fractures.
You can find the publication here: https://www.nejm.org/doi/full/10.1056/NEJMoa2113514
Clinical dietitian Dr Jack Bell from Prince Charles Hospital in Brisbane and clinical nutritionist Assistant Prof Ólöf Guðný Geirsdóttir from the University of Iceland discuss the importance of interdisciplinary nutritional management and care of older adults based on their recently published open access textbook. This text is a fantastic resource to assist nursing nutritional care in particular.
You can find the publication here: https://link.springer.com/book/10.1007/978-3-030-63892-4
On this episode, Dr Hannah Seymour joins the podcast to talk about the Clinical Frailty Scale, a judgement-based frailty tool that evaluates specific domains including comorbidity, function, and cognition. Dr Seymour is a geriatrician based at Fiona Stanley Hospital in Western Australia and she has been researching effectiveness of employing the Clinical Frailty Scale in predicting mortality in hip fracture care.
Publication:
Narula, S., Lawless, A., D’Alessandro, P., Jones, C. W., Yates, P., & Seymour, H. (2020). Clinical Frailty Scale is a good predictor of mortality after proximal femur fracture: A cohort study of 30-day and one-year mortality. Bone & joint open, 1(8), 443-449.
Suggested Resources:
AIMS Research Group - Clinical Frailty Scale Training ModuleDalhousie University Clinical Frailty Scale Guidance and Training
On this episode, Professor Alison Mudge joins to discuss Eat Walk Engage, a comprehensive multi-disciplinary program preventing delirium and improving care for older people in hospital. Professor Mudge is the Clinical Lead for the Queensland statewide Eat Walk Engage program, Metro North Clinician Research Fellow and Professor of Medicine at the Royal Brisbane Clinical Unit.
You can find the mentioned publication of the Eat Walk Engage program here.
To find out more information on this fantastic program contact:
Professor Alison Mudge: Alison.Mudge@health.qld.gov.au
Eat Walk Engage: EatWalkEngage@health.qld.gov.au
Join ANZHFR research assistant Niamh Ramsay as she walks you through the new ANZHFR website and its functions.
Play along by going to anzhfr.org or check out the video version of this episode here.
Dr Sandra Iuliano, a senior research fellow in Endocrinology from the University of Melbourne, shares the results of her study The Effect of Dietary on how adequate calcium & protein intake can reduce falls & fractures in aged care residents.
Iuliano, S., Poon, S., Robbins, J., Bui, M., Wang, X., De Groot, L., ... & Seeman, E. (2021). Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomised controlled trial. bmj, 375.
You can find this British Medical Journal publication here.
Join co-chairs Prof Jacqui Close, Prof Ian Harris & Catherine McDougall and Australian Registry Manager Jamie Hallen as we review 2021 and discuss the plans to come. A big thank you to our listeners for supporting our podcast and mission to improve hip fracture care.
Princess Alexandra took out the ANZHFR 2021 Australian Golden Hip Award this year, and on this episode, their Orthopaedic Clinical Nurse Consultant Naomi O'Rourke shares an insight into how their department has become a top performing Australian hospital in hip fracture care.
On this episode, Geriatrician Dr Min Yee Seow from Waitemata District Health Board provides an insight into hip fracture care at North Shore Hospital. Waitemata’s North Shore Hospital was the ANZHFR 2021 New Zealand Golden Hip Award winner, so tune in to heartheir secrets to success as a top performing hospital in Australia in hip fracture care .
A recent Hipfest presentation by Dr Sharon Carey on pre-operative fasting in the person with a hip fracture. Dr Carey is the Head of Nutrition and Dietetic & Director of Allied Health Research and Education, Institute of Academic Surgery at Royal Prince Alfred Hospital.
Thank you to Dr Jack Bell for his introduction of Dr Carey for the episode and for leading the Q&A session following the talk.
A recent Hipfest panel discussion around the early mobility of patients following hip fracture surgery. Physiotherapist Brett Baxter leads the multidisciplinary discussion with anaesthetics, surgery, physiotherapy and nursing representatives discussing the barriers to achieving early mobilisation post-operatively for patients with hip fracture.
The video can be watched here
Dr Seth Tarrant, an orthopaedic surgeon for the John Hunter Trauma Service, provides an overview of the evidence for the use of tranexamic acid acid in hip fracture surgery. This is followed by a Q&A with orthopaedic surgeon Dr Catherine McDougall.
Watch the video version here.
Highlighted studies:
1. Palija, S., Bijeljac, S., Manojlovic, S., Jovicic, Z., Jovanovic, M., Cvijic, P., & Dragicevic-Cvjetkovic, D. (2021). Effectiveness of different doses and routes of administration of tranexamic acid for total hip replacement. International orthopaedics, 45(4), 865-870.
-
Gayet-Ageron, A., Prieto-Merino, D., Ker, K., Shakur, H., Ageron, F. X., Roberts, I., ... & Pepple, T. (2018). Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients. The Lancet, 391(10116), 125-132.
-
Zufferey, P. J., Miquet, M., Quenet, S., Martin, P., Adam, P., Albaladejo, P., ... & investigators of the tranexamic acid in hip-fracture surgery (THIF) study. (2010). Tranexamic acid in hip fracture surgery: a randomized controlled trial. British Journal of Anaesthesia, 104(1), 23-30.
-
Tengberg, P. T., Foss, N. B., Palm, H., Kallemose, T., & Troelsen, A. (2016). Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial. The bone & joint journal, 98(6), 747-753.
-
Zhou, X. D., Zhang, Y., Jiang, L. F., Zhang, J. J., Zhou, D., Wu, L. D., ... & Xu, N. W. (2019). Efficacy and Safety of Tranexamic Acid in Intertrochanteric Fractures: A Single‐Blind Randomized Controlled Trial. Orthopaedic surgery, 11(4), 635-642.
-
Haj-Younes, B., Sivakumar, B. S., Wang, M., An, V. V., Lorentzos, P., & Adie, S. (2019). Tranexamic acid in hip fracture surgery: a systematic review and meta-analysis. Journal of Orthopaedic Surgery, 28(1), 2309499019887995.
-
Nikolaou, V. S., Masouros, P., Floros, T., Chronopoulos, E., Skertsou, M., & Babis, G. C. (2021). Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial. The Bone & Joint Journal, 103(3), 442-448.
-
Ma, H., Wang, H., Long, X., Xu, Z., Chen, X., Li, M., ... & Liu, X. (2021). Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial. Journal of Orthopaedic Surgery and Research, 16(1), 1-7.
-
You, D., Skeith, L., Korley, R., Cantle, P., Lee, A., McBeth, P., ... & Schneider, P. (2021). Identification of hypercoagulability with thrombelastography in patients with hip fracture receiving thromboprophylaxis. Canadian Journal of Surgery, 64(3), E324.
Dr Seth Tarrant can be contacted via sethtarrant@gmail.com.
Professor David Scott Anaesthetist and Director of the Department of Anaesthesia and Acute Pain Medicine at St Vincent’s Hospital Melbourne discusses his research in anaesthesia and delirium from the BALANCED Delirium study recently published in the British Journal of Anaesthesia.
The study publication can be found here: https://www.sciencedirect.com/science/article/pii/S0007091221004931?dgcid=author
Dr Catherine McDougall, Orthopaedic Surgeon and Clinical Director of Surgery at STARS in Metro North Brisbane and Co-Lead of the Getting It Right The First Time (GIRFT) program shares the achievements of the program in hip fracture care in Queensland.
Click the link for more information:
UK: https://www.gettingitrightfirsttime.co.uk
QLD: https://clinicalexcellence.qld.gov.au/priority-areas/service-improvement/girft
A/Prof Mellick Chehade, an Orthopaedic Trauma Consultant from Adelaide, discusses his work developing digital healthcare for patients with hip fractures.
Click here for more information: https://www.who.int/bulletin/volumes/98/8/19-249136.pdf
If you wish to find out more, please find A/Prof Chehade's contact details here: https://researchers.adelaide.edu.au/profile/mellick.chehade
Centre for Research Excellence in Frailty and Healthy Ageing: https://health.adelaide.edu.au/frailty-healthy-ageing/
Stephanie Thornton, Nurse Management Consultant, Central Australia Health Service, discusses the unique physical and cultural challenges of hip fracture care in a remote setting. Hear Stephanie discuss issues of transporting patients long distances, engaging with patients in a culturally appropriate manner and the necessity to think outside the box with regard to equipment provision!
This week join the ANZHFR team for the inaugural ANZHFR New Zealand Golden Hip 2021 award. The Golden Hip was initiated by the Scottish Hip Fracture Audit to promote and reward better health care for people with hip fractures.
For the first time in New Zealand, four finalist hospitals will be recognised for their achievements against the Hip Fracture Care Clinical Care Standard quality indicators. The top performing hospital will be awarded the New Zealand Golden Hip 2021 award.
See the video version of this ceremony: https://youtu.be/9hZeLoeMfJU
This week join the ANZHFR team for the inaugural ANZHFR Australian Golden Hip 2021 award. The Golden Hip was initiated by the Scottish Hip Fracture Audit to promote and reward better health care for people with hip fractures.
For the first time in Australia, ten finalist hospitals will be recognised for their achievements against the Hip Fracture Care Clinical Care Standard quality indicators. The top performing hospital will be awarded the 2021 Australian Golden Hip award.
See the video version of this ceremony: https://youtu.be/TIq6xSQZx00
Join ANZHFR co-chairs Prof Jacqui Close & Prof Ian Harris and Australian Registry Manager Jamie Hallen to discuss the recently published ANZHFR Annual Report 2021.
Orthopaedic surgeons Dr Catherine McDougall & Dr Lorenzo Calabro discuss the options for the surgical management of intertrochanteric fractures.
A video version of this talk is available at: https://www.youtube.com/watch?v=y7M7t01n_rQ
Adjunct Associate Professor Paul Mitchell, Chair of the Communications Committee of the Fragility Fracture Network provides an introduction to the network and their global call to action.
Here are some useful links for podcast listeners:
- FFN Global Congress, 28-30 September - https://www.fragilityfracturenetwork.org/project/welcome-message/
- Global Call to Action on Fragility Fractures and FFN Clinical and Policy Toolkits - https://www.fragilityfracturenetwork.org/cta/
- Asia Pacific Fragility Fracture Alliance-FFN Hip Fracture Registry Toolbox - https://apfracturealliance.org/hfr-toolbox/
Anaesthetist Dr Richard Halliwell discusses the considerations for analgesia in the older hip fracture patient. Richard presents the research evidence, together with the risks and benefits for different anaesthetic and pain relief approaches. This is followed by a Q&A with ANZHFR Co-chair Prof Jacqui Close.
NSW Agency for Clinical Innovation Fascia Iliaca Block guide found here: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/285592/Fascia-Iliaca-Block-Guide.pdf
Systematic Review of the Effects of Fascia Iliaca Compartment Block on Hip Fracture Patients Before Operation (2018): https://www.bjanaesthesia.org/article/S0007-0912(18)30041-2/fulltext
Cochrane Review (2018) on EEG and delirium mentioned:
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011283.pub2/full
Geriatrician, Dr Chrys Pulle, presents his hospital’s experience in improving performance on Clinical Indicator 6 – “Minimising the risk of another fracture”. Chrys discusses how identification of at-risk patients, investigation of risk factors and individualised treatment plans for falls prevention and treatment of osteoporosis are a cost effective approach to significantly reduce the risk of further fractures, pain, suffering and hospitalisation
Professor Jacqueline Close discusses the effects of delirium on patient outcomes and highlights recent research in this area. Jacqui provides information regarding strategies for preventing delirium such as pain management, nutrition and hydration, time to surgery, bladder and bowel management and involvement of carers. This is followed by a short Q&A session with Dr Hannah Seymour.
Please find the meta-analysis mentioned here: https://jamanetwork.com/journals/jamasurgery/article-abstract/2432614
Please find the HIP ATTACK study mentioned here:
https://www.sciencedirect.com/science/article/pii/S0140673620300581
Please find the music therapy & sleep quality study mentioned here:
https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.17149
Please find the study on intranasal administration of insulin and delirium mentioned here:
https://www.sciencedirect.com/science/article/abs/pii/S1064748121002165
Prof Ian Harris leads a panel discussion on the subject of anticoagulants and hip fracture. Hear the perspectives of orthopaedic surgeon Dr Chris Jones, anaesthetist Dr Sean McManus, geriatrician Dr Hannah Seymour and haematologist Dr Stephanie Ping as they discuss several case studies which highlight some of the considerations around this issue.
Please find the mentioned Association of Anaesthetists (2020) resource here:
https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Management%20of%20hip%20fractures%202020.pdf?ver=2021-01-21-143705-287
Join Prof Ian Harris, co-chair of ANZHFR for a Q & A with Dr Jack Bell, Dietitian from The Prince Charles Hospital, Queensland and ANZHFR Steering Committee member. Dr Jack Bell discusses the importance of malnutrition and SIMPLE nutrition care for hip fractures.
Successful multidisciplinary care can be a challenge. Join our expert panel to hear about the triumphs and barriers to achieving cohesive teamwork for throughout the hospital journey for hip fracture patients.
Our guest panel:
Subacute Team Representations from Orange General Hospital NSW:
-
Kate Polain - Rehabilitation Clinical Nurse Consultant
-
Josie Lowe - Dietitian
-
Jo Upson - Physiotherapist
Brett Baxter - Physiotherapist, Princess Alexandra Hospital QLD
Dr Sarah Hurring - Geriatrician, Burwood Hospital NZ
Prof Gustavo Duque, a Melbourne-based Geriatrician discusses a pilot study by his research team on the implementation of an electronic care pathway for hip fracture patients and the benefits of this on the patient hospital journey.
For more information, please take a look at the published paper: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03834-w
Talevski, J., Guerrero-Cedeño, V., Demontiero, O. et al. Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study.BMC Musculoskelet Disord 21, 837 (2020). https://doi.org/10.1186/s12891-020-03834-w
Join Prof Jacqui Close, co-chair of ANZHFR for a Q & A with Dr Bianca Wong, Geriatrician from the Lyell McEwin Hospital, South Australia. Dr Bianca Wong discusses how they are able to achieve a high rate of initiating osteoporosis medication at her hospital.
Anaesthetists, Dr John Barry and Dr Sean McManus discuss the role of the anaesthetist in the care of patients with fractured neck of femurs, including the challenges of pain management in the older patient, particularly those with cognitive impairment. Elderly patients with hip fracture are at risk of being undertreated for pain which can contribute to longer lengths of stay and poorer functional outcomes. John and Sean discuss the advantages and disadvantages of different modes of analgesia that are available and the clinical significance of fascia and femoral nerve blocks.
This week we have New Zealand senior physiotherapist Claire Turner sharing her experience on the benefits of early mobilisation for hip fracture patients.
A follow up session from the recent Australian Hipfest, our experienced Registry experts Elizabeth Armstrong and Stewart Fleming answer some of the audience's burning questions on involvement in the Registry.
With our expert panel of ANZHFR Co-Chairs Prof Close & Prof Harris, geriatrician Dr Seymour & anaesthetist Dr McManus, we will be answering your burning questions on anticoagulation and surgery, delirium, pain management and bone protection for your hip fracture patients.
Links:
1. Anticoagulation & Surgery Resource: Association of Anaesthetists of Great Britain & Ireland - https://anaesthetists.org/Portals/0/PDFs/Guidelines%20PDFs/Management%20of%20hip%20fractures%202020.pdf?ver=2021-01-21-143705-287
- Bone Protection: RACP Osteoporosis Guideline: https://healthybonesaustralia.org.au/wp-content/uploads/2020/11/OA-RACGP-Osteoporosis-Clinical-Guidelines-Summary-ver-2018.pdf
Professor Maria Fiatarone Singh is a Geriatrician at The University of Sydney, New South Wales. She describes her research in rehabilitation after hip fracture and the effects of high intensity progressive resistance training as well as targeted multi-disciplinary treatment. She gives context to the randomised control study and describes how this research can be translated into a wider scope.
Dr Matthew Beech, Staff Specialist Anaesthetist at Gold Coast University Hospital, QLD Australia and Prof Jacqui Close, co-chair of ANZHFR discuss the role of transthoracic echo in hip fracture.
Mr Peter Moules, a registered nurse in ED, describes how care was improved with an innovative eHIP bundle of care and prompt notification system involving the MDT Hip Fracture team at Wollongong Hospital, New South Wales, Australia.
Dr Lara Kimmel, team leader and physiotherapist describes how High Intensity Physiotherapy for Hip Fractures is provided at The Alfred Hospital, Victoria, Australia. Dr Kimmel presents the results of the HIP4Hips randomised control trial and explains how they are able to provide this model of physiotherapy as “business as usual” at The Alfred.
Dr Agnes Yuen is a Haematologist from Melbourne Haematology and research fellow at Monash Health, Victoria, Australia. She will be discussing direct oral anticoagulants and emergency hip fracture surgery.
Taken from the 2020 Hipfest Lecture Series, Dr Hannah Seymour, Geriatrician at Fiona Stanley Hospital, Western Australia and Prof Jacqui Close, co-chair of ANZHFR discuss when not to operate on hip fracture patients towards the end of their lives.
Consultant orthopaedic surgeons, Dr Marinis Pirpiris and Prof Ian Harris discuss the use of total hip replacements versus hip hemiarthroplasty in the management of hip fractures as well as the use of dual mobility hip replacements.
Improving time to surgery for hip fracture patients: Dr Saqib Zafar, Orthopaedic surgeon tells us how this was achieved with a dedicated hip fracture team at Nepean Hospital in New South Wales, Australia.