title: Feasibility and Efficacy of Function-Focused Care for Orthopedic Trauma Patients.
abstract: To overcome challenges associated with optimizing function and physical activity among hospitalized older adults, we developed function-focused care for acute care (FFC-AC). The purpose of this study was to test the feasibility and preliminary effectiveness of this intervention. We hypothesized that hospitalized trauma patients exposed to FFC-AC would (1) maintain or improve function, spend more time in physical activity, and have fewer adverse events between admission and discharge; and (2) maintain or improve function, have less fear of falling, fewer depressive symptoms, less pain, be more physically resilient, and be less likely to experience adverse events at 1 month postdischarge compared with those exposed to FFC-education only (EO). FFC-AC was implemented by a research function-focused care nurse who worked on the participating units for 20 hr a week for 16 months to implement the three components of FFC-AC. The sample included 89 older orthopedic trauma patients the majority of whom were female (N = 59, 66%), white (N = 82, 92%), and not married (N = 53, 59%). At discharge and/or 30 days postdischarge, participants in the treatment site showed greater improvement in function, less fear of falling, and better physical resilience when compared with those in the FFC-EO site. Future research is needed to continue to work on engaging staff in function-focused care approaches and optimizing the hospital environment and policies to support nurses in this type of care approach.
authors.affiliation: University of Maryland School of Nursing, Baltimore (Drs Resnick, Galik, and Zhu, and Mss Holtzman and Laidlow); University of Maryland School of Medicine, Baltimore (Dr Wells); University of Maryland Medical Center, Baltimore (Ms Gamertsfelder); and Boston College, Chestnut Hill, Massachusetts (Dr Boltz).
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.forename: Chris
authors.initials: C
authors.lastname: Wells
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Galik
authors.forename: Lauren
authors.initials: L
authors.lastname: Holtzman
authors.forename: Shijun
authors.initials: S
authors.lastname: Zhu
authors.forename: Elise
authors.initials: E
authors.lastname: Gamertsfelder
authors.forename: Terry
authors.initials: T
authors.lastname: Laidlow
authors.forename: Marie
authors.initials: M
authors.lastname: Boltz
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D015444:Exercise / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000628:therapy*; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009985:Orthopedics; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care / Q000458:organization & administration*; D010809:Physical Fitness / Q000502:physiology*; D014193:Trauma Centers; D014481:United States