Irish Hip Fracture Database National Report 2020

Irish Hip Fracture Database National Report 2020

In 2020, despite the impact of COVID-19 on our health service, the IHFD collected data from all 16 acute hospitals on 99% (3,666) of patients aged 60 years or over who were hospitalised following a hip fracture. The consequences of this common, serious injury for the individual, society and our health system are significant. For individuals, a hip fracture affects mobility and function, where they live, and even their survival.

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Key Findings

Home continues to be the place patients are most likely to be admitted to hospital from with a hip fracture (85%). The average age of hip fracture patients is 81 years and over two-thirds (67%) are female.

Be Active at Home

The 2020 report places a key focus on Being Active at Home. Due to COVID-19, many people were spending more time in their homes, resulting in reduced activity levels. A clear message is that keeping active throughout the day can help older adults to keep well physically, reducing the risk from harmful falls, and mentally by continuing to be part of their communities.

Key Recommendations

  • ​Recommendations for NOCA

    • The National Office of Clinical Audit (NOCA) will continue to implement the new Irish Hip Fracture Standard (IHFS) 7 for early mobilisation, with a plan to add it to the Best Practice Tariff (BPT) in 2022.
    • Through research, NOCA will progress the development of longer-term outcome measures for hip fracture.
  • Recommendations for the HSE

    The Health Service Executive (HSE), through the National Clinical Programme for Trauma and Orthopaedic Surgery, will:

    • promote and develop bundles of care in conjunction with the Irish Hip Fracture Database (IHFD), e.g. pre-hospital, emergency department (ED), orthogeriatrics, anaesthetics, orthopaedics and rehabilitation
    • advocate that no patient should be fasted repeatedly
    • promote the practice of performing a nutrition and delirium screen for all hip fracture patients
    • promote community pathways in order to enable early supported discharges.
  • ​Recommendations for Clinicians, Hospitals Managers and Audit Coordinators

    • The hip fracture governance committees (HFGCs) should continue to meet regularly in order to review the data and engage in quality improvement using the data.
    • Focus on increasing compliance with the IHFS in order to attain the BPT, which includes the new IHFS 7 for early mobilisation from 1 January 2022.
    • Evaluate local processes/protocols for pre-operative fasting, delirium screening and nutrition screening.