title: The National Hip Fracture Database (NHFD) - Using a national clinical audit to raise standards of nursing care.
abstract: The National Hip Fracture Database (NHFD) is a key clinical governance programme for staff working in trauma wards across England, Wales and Northern Ireland. It uses prospectively collected information about the 65,000 people who present with hip fracture each year, and links these with information about the quality of care and outcome for each individual. The NHFD can, therefore, provide a picture of the care offered to frail older people with this injury - people who, between them, occupy nearly half of inpatient trauma beds. The NHFD uses its website (www.nhfd.co.uk) to feed back live information to each of the countries' 180 trauma units - allowing them to bench mark their performance against national standards, and against that in other hospitals. This helps to develop a consensus over the best care for frail older people in areas where national guidance is not yet available. This article shows how the NHFD is contributing to four key aspects of patient safety and nursing care: the prevention of pressure ulcers and post-operative delirium, the monitoring of falls incidence across hospitals and nutritional assessment of patients with hip fracture.
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK. Electronic address: antony.johansen@wales.nhs.uk.
authors.forename: Antony
authors.initials: A
authors.lastname: Johansen
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Boulton
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Hertz
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Ellis
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Burgon
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Sunil
authors.initials: S
authors.lastname: Rai
authors.affiliation: National Hip Fracture Database (NHFD), Falls and Fragility Fracture Audit Programme (FFFAP), Royal College of Physicians, London, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Wakeman
mesh_terms: D019985:Benchmarking; D016208:Databases, Factual / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000453:epidemiology* / Q000451:nursing; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data*; D009729:Nursing / Q000592:standards*; D017063:Outcome Assessment, Health Care; D013222:State Medicine; D006113:United Kingdom / Q000453:epidemiology