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OBJECTIVES: To examine patient, surgical and hospital factors associated with Day-1 postoperative mobility after hip fracture surgery in older adults. METHODS: A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day-1 after hip fracture surgery. RESULTS: Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day-1. Odds of actual first-day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62-0.82) or two aids or frame (OR = 0.57, 95% CI 0.52-0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17-0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51-0.64); from aged care facilities (OR = 0.59, 95% CI 0.52-0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41-0.97), 3 (OR = 0.31, 95% CI 0.20-0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14-0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71-0.91); and restricted/non-weight-bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42-0.67). CONCLUSIONS: Both non-modifiable and modifiable patient and surgical factors influence first-day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day-1 postoperative mobility.
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Social media is a valuable tool in the practice of medicine, but it can also be an area of 'treacherous waters' for medical students. Those in their upper years of study are off-site and scattered broadly, undertaking clinical rotations; thus, in-house (university lecture) sessions are impractical. Nonetheless, during these clinical years students are generally high users of social media technology, putting them at risk of harm if they lack appropriate ethical awareness. We created a compulsory session in social media ethics (Doctoring and Social Media) offered in two online modes (narrated PowerPoint file or YouTube video) to fourth- and fifth-year undergraduate medical students. The novelty of our work was the use of SurveyMonkey® to deliver the file links, as well as to take attendance and deliver a post-session performance assessment. All 167 students completed the course and provided feedback. Overall, 73% Agreed or Strongly Agreed the course session would aid their professionalism skills and behaviours, and 95% supported delivery of the curriculum online. The most frequent areas of learning occurred in the following topics: email correspondence with patients, medical photography, and awareness of medical apps. SurveyMonkey® is a valuable and efficient tool for curriculum delivery, attendance taking, and assessment activities.