Nursing Care of Hospitalised Orthopaedic Patients

Patients hospitalised in orthopaedic wards usually suffer from traumatic injuries (e.g. fractures, dislocations, spinal cord injuries, open trauma, strains), which may have been caused by low-energy trauma (e.g. fragility fractures) or high-energy trauma (e.g. road traffic accidents or occupational accidents), or they may need hospitalisation after an elective surgery (e.g. total joint arthroplasty). In any case, their care is complicated, either due to the severity of the injury and the subsequent surgical operation, or due to multi-morbidity and complications. This article first summarizes the nursing assessments of patients with orthopaedic health problems, which includes the gathering of objective and subjective data regarding both the patient's general health status as well as data about the musculoskeletal system in particular. This is followed by sections about pain management, the importance and methods of early mobilisation postoperatively and the management of the main perioperative complications [such as thromboembolism, fat embolism, compartment syndrome, hospital-acquired infections (pulmonary and urinary catheter-associated) and delirium]. Finally, interventions about ensuring adequate nutrition and good bowel function and pressure ulcers prevention are presented and the role of patient and family education in recovery and rehabilitation is highlighted. In each section both elements of nursing assessments and some of the possible nursing interventions are presented. Nursing staff, through an ongoing patient assessment, a systematic recording of findings and the implementation of nursing interventions (many of which are independent, such as education), achieves holistic and individualised coverage of patients' needs.