British Orthopaedic Association's Standards for Trauma (BOAST): Care of the older or frail patient with orthopaedic injuries.

Managing elderly, frail patients with orthopaedic injuries, remains a challenge. Their poor bone stock and associated comorbidities makes this special cohort of patients unique in terms of their needs and the risk of developing complications. Published on line in 2019 (www.boa.ac.uk/uploads/assets/04b3091a-5398-4a3c-a01396c8194bfe16/the%20care%20of%20the%20older%20or%20frail%20orthopaedic%20trauma%20patient.pdf) the British Orthopaedic Association's Standards for Trauma focusing on the care of the older or frail patient with orthopaedic injuries, provides a contemporary guide for the holistic management of the spectrum of injury and pre-existing needs of this population.

Reducing attendance at trauma clinics by providing first-point-of-contact treatment.

In 2016, the urgent and ambulatory care service in Oxfordshire formed part of a cross-organisational partnership working group. The group consisted of Oxford Health NHS Foundation Trust community minor injury units (MIUs) at Abingdon and Witney, and Oxford University Hospitals NHS Foundation Trust (OUH) trauma and orthopaedic specialties and emergency department (ED). The aim was to redesign fracture management pathways and delivery of definitive care at patients' first point of contact with the NHS. This article discusses the implementation of the trauma pathways in two of Oxfordshire's community MIUs. In total, a range of seven common fracture pathways seen in the ED and community MIUs were redesigned so that patients were treated definitively at the first point of contact and discharged with a safety net supported by leaflets; a direct contact facility to OUH trauma specialties was part of the safety net allowing patients to self-refer to the trauma clinic if they had any concerns. In total, 513 patients were treated and discharged on see, treat and discharge fracture pathways in the first year of pathway operation, which represented a 21% decrease in patient referral rates to the trauma clinic at OUH compared with the previous year.

Exploring the nurse practitioner role in managing fractures in long-term care.

The purpose of this study was to assess the current level of involvement of nurse practitioners (NPs) in activities related to preventing and managing fractures in long-term care (LTC). This study used a sequential explanatory mixed methods design that included two phases-a cross-sectional survey followed by qualitative interviews. A final sample of 12 NPs completed the online survey for a response rate of 67%. Eleven of the 12 NPs who completed the survey agreed to participate in a follow-up interview. NPs reported that they were quite engaged in managing fractures in LTC; specifically, they were most active in caring for residents post-fracture. NPs described their role as being holistic in nature in their assessment and treatments related to managing fractures. The findings from this mixed method study add to the growing body of knowledge related to how NPs manage fractures in LTC.

[The silent disease: the quality of life of women with osteoporotic fracture].

For the past 5 years, the WHO has held World Osteoporosis Day on 20 10. This has highlighted the importance of preventing the disease. Osteoporosis has been called a silent disease. Fractures are the first sign to be noticed and the worst fracture is a hip fracture. The mortality rate associated with hip fracture is 15-36% which is higher than that for cancer victims in their first year as cancer sufferers. Half of those who survive face pain, disability and dependence. They also require the medical devices to assist activity throughout their life and have to live in nursing homes to receive care. This has a profound affect on the patient's health and quality of life. Assessment of quality of life has become a very important tool to evaluate patients with osteoporotic fracture. The advantages of such assessments include establishing the direction of treatment, promoting general quality of life, and reducing the risk of further fracture. A multidisciplinary approach is the best holistic strategy for combining medicine, nursing, nutrition, and rehabilitation to increase the general quality of life of women with osteoporotic fractures.

Tai Chi as a method of fall prevention in the elderly.

Falls often lead to the fracture of bones in the elderly population. Fall incidence is increasing with the concomitant rise in the elderly population. Recently, some nontraditional methods of fall prevention have been explored. This article provides some background information about the ancient practice of Tai Chi as well as a brief review of the current literature exploring the effectiveness of Tai Chi in health promotion and fall prevention.