Clinical team who improved management of frail elderly patients shortlisted for UK Parliamentary award | Research News and Media

A clinical team who created a new pathway to help manage frail orthopaedic patients has been shortlisted for a prestigious NHS Parliamentary award.

Nursing staff at Nottingham University Hospitals NHS Trust (NUH) worked with clinical academics at the University of Nottingham to open the first Orthopaedic Frailty Admission and Discharge Unit (FADU) in the UK at the Queens Medical Centre, Nottingham, last year.

The creation of this pathway meant the construction of a new-bedded unit, where older patients admitted following critical injuries such as hip fractures receive dedicated nursing care in a purpose designed environment. The unit is designed to support the most vulnerable older patients sustaining an injury. The FADU unit has been praised for having a “beneficial impact on patients physically, psychologically and emotionally”.

Nottinghamshire MPs Alex Norris, Nadia Whittome, Lilian Greenwood, Steve Yemm and James Naish have nominated the FADU Team for a NHS Parliamentary Award in the Nursing and Midwifery awards category.

NUH is one of the largest providers of hip fracture care in the UK, treating over 850 such cases a year and the only acute trust in Nottinghamshire. Orthopaedic and trauma surgeon and senior researcher Professor Benjamin Ollivere worked with Emily Mulvaney, Trainee Advanced Clinical Practitioner, and other NUH staff, to establish FADU in 2023.

Professor Ollivere, whose research work includes studies looking at frailty and how to achieve better outcomes for these patients, said: “We are delighted that this specialist unit has proved its worth since its establishment. Frail older patients who are admitted through this new pathway benefit in terms of improved outcomes, due to our dedicated treatment approach.

“Additionally, the creation of this pathway has helped relieve our very busy ED team of some of the pressures involved in managing this group of vulnerable patients, allowing them to help other patients in need of critical care.”

Emily Mulvaney said: “In looking to improve outcomes for this group of frail patients, we knew a dedicated facility for these patients could potentially support up to two-thirds of trauma and orthopaedic patients, or 70 per cent of hip fracture patients who are admitted.

“Our team identified a suitable space within the QMC and converted it into a purpose-built unit for our frailest patients. Throughout the process of establishing FADU, we worked closely with our colleagues in ED, who we meet regularly to discuss improvements we can make for these patients together. We are really honoured to receive this recognition within the UK Parliamentary awards.”

The four-bed unit is open from 7am – 7.30pm, seven days a week. During its first twelve months, 625 patients have been admitted via this pathway. During this time the unit has been shown to reduce the chances of confusion and delirium, as well as ensure timely and appropriate care resulting in a significantly higher chance of surviving what can be a devastating injury.

Patients who are transferred to FADU receive specialist nursing care as soon as they arrive on the unit. They can be seen with their relatives in a quieter environment, and are optimised pre-operatively before they undergo surgery.