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Patients with a hip fracture may be appropriately delayed for surgery as they require optimisation or clinical interventions to treat acute medical illnesses (Moja et al., 2012). Other patients are inappropriately delayed due to hospital factors (Brener, 2013; Lee & Elfar, 2014). Timely efficient admission and surgery is well documented as the best course of management for these patients. The aim of this prospective cohort longitudinal follow-up study was to establish if a relationship existed between duration of time spent in the Emergency Department (ED), time to surgery and functional ability in patients with hip fractures and to examine the effect prolonged waits may have on ability to return home. Functional ability for fifty one patients with a hip fracture was evaluated using the Barthel Index Score (BIS) on admission and at six weeks post-surgery. Data were analysed by using SPSS version 20. The findings reveal a change in BIS at 6 weeks for patients whose surgery is delayed. Patients who experienced long delays awaiting admission (>12 h) in the ED functioned less well (Kruskal-Wallis test p = 0.033). Correlation existed between time to surgery and returning to pre-fracture place of residence, (p = 0.000 Pearson chi-square), which also remained significant while controlling for age. Prolonged waits had an overall negative impact on patients’ post-fracture functional ability. This study highlights the deleterious effects on functional ability when surgery is delayed. [ABSTRACT FROM AUTHOR]

Based on the experience of using the poem 'The Nurse's Pockets' by Cortney Davis in reflective practice teaching sessions this paper considers the centrality of language as conveyed in poetry as a way of communicating nursing knowledge and experience. Using this poem facilitated a mutual position between the educator and the students that enhanced the reflective practice environment. An argument for using creative arts based approaches in nurse education is presented as a means of overcoming the threats to the unique nature of nursing knowledge evidenced in healthcare and higher education reform. [ABSTRACT FROM AUTHOR]

Summary: This study explores patient satisfaction with an orthopaedic pre-operative assessment clinic. A quantitative exploratory approach was adopted using a pre-validated questionnaire. The introduction of pre-operative assessment clinics (POAC) has been recommended as a quality initiative to reduce surgical cancellations and enhance the patient journey to surgery. Yet patient satisfaction with this service has not yet been evaluated within an Irish context. A sample of 91 patients who attended the POAC were invited to participate in the study and a response rate of 88% was achieved. A modified version of the Leeds Satisfaction Questionnaire was administered to patients no sooner than four days post surgery. The findings suggest that in general patients were satisfied with the care provided in the POAC, but areas for improvement were identified in the matters of providing individualised care and information to patients. Recommendations for future research include further exploration into the information needs of patients undergoing joint replacement surgery and an evaluation of the importance of individualised care from the patients’ perspective. [Copyright &y& Elsevier]

Summary: considers the ability to reflect as an imperative component for the development of competency. This paper highlights the benefit of reflection as demonstrated by a student undertaking an orthopaedic nursing programme, at higher diploma level. It will demonstrate that by using reflection as a learning tool the progression from the level of experienced practitioner (at point of entry to the course) to proficient practitioner (at point of departure) can be developed (Benner, P., 1984. From novice to expert. Excellence and Power in Clinical Nursing Practice. Addison-Wesley, California). [Copyright &y& Elsevier]