Nursing Care of an Elderly Patient with Hip Fracture Complicated by Hospital-Acquired Infection in a Community Hospital : Case Study.

Abstract

     This study was case study aimed to examine the nursing process and approaches for preventing complications in elderly patients with hip fractures complicated by infections in various body systems, including dementia. The patient in this case study was an 89-year-old Thai woman with a history of falling, resulting in a closed fracture of the left neck of femur. The patient and her relatives refused surgical treatment. She was admitted to Maharaj Nakhon Ratchasima Hospital for 3 days before being referred to a community hospital near her home for continued treatment. The patient also had pulmonary embolism, left lower lobe pneumonia (LLL pneumonia), and dementia. Therefore, conservative treatment was provided, along with close monitoring and nursing care by the healthcare team. Nursing care focused on the prevention of complications, respiratory care, nutritional support, infection surveillance, and implementation of the Advance Care Plan (ACP).

     The results showed that the patient remained in stable condition without new infections or fever. She tolerated tube feeding well and developed no pressure ulcers. Her relatives demonstrated understanding and cooperation in the care process. The application of a systematic nursing process together with multidisciplinary team collaboration contributed to appropriate and safe patient care, prevented complications related to treatment, and reduced the risk of additional infections.