臨床的隱憂─住院病人之自發性骨折

自發性骨折已逐漸成為現在臨床照護的顯學，但是護理相關領域的研究或文章卻仍闕如。自發性骨折所衍生的醫療糾紛卻可能直接衝擊第一線照護者—護理人員，以當前全台仍處於護理人力短缺的情況，臨床上若發生這類事件，恐對護理工作環境雪上加霜。因此，本篇文章透過文獻蒐集及整合方式，瞭解目前臨床上自發性骨折的流行病學，並進一步整合相關自發性骨折的預防及處理之實證資料。藉此喚起臨床醫護人員的重視，期盼臨床上能建立自發性骨折高危險群的篩選機制，透過更積極主動的介入措施，強化民眾或病人及家屬的認知，尤其提供給辛苦為提升病人照護品質的護理人員們做為參考。

關鍵字

自發性骨折；微創性骨折；住院骨折；護理；長期照護

並列摘要

Spontaneous fracture is an issue of increasing concern in clinical care. However, this topic has received only limited attention in nursing research. Gaps in understanding related to spontaneous fractures may increase medical-legal risks faced by frontline care nurses, exacerbate nursing pressures, and serve as a disincentive to remain in the already understaffed nursing profession. This article reviews previous research on spontaneous fractures to determine the epidemiological causes of clinical spontaneous fracture and identify effective prevention strategies. We hope this paper may increase clinical practitioner and expert awareness of spontaneous fractures; help establish a screening mechanism to identify high risk spontaneous fracture patients; and help nurses develop and implement proactive prevention / treatment strategies to strengthen awareness of this topic among patients and their families.

並列關鍵字

spontaneous fracture ； minimal-trauma fracture ； hospitalized fracture ； nursing ； long term care

參考文獻

Colón-Emeric, C., Kuchibhatla, M., Pieper, C., Hawkes, W., Fredman, L., Magaziner, J., … Lyles, K. W. (2003). The contribution of hip fracture to risk of subsequent fractures: Data from two longitudinal studies. Osteoporosis International, 14(11), 879－883. doi:10.1007/s00198-003-1460-x

Colón-Emeric, C. S., Lyles, K. W., House, P., Levine, D. A., Schenck, A. P., Allison, J., … Saag, K. G. (2007). Randomized trial to improve fracture prevention in nursing home residents. The American Journal of Medicine, 120(10), 886 －892. doi:10.1016/j.amjmed.2007.04.020

Dorne, H. L., & Lander, P. H. (1985). Spontaneous stress fractures of the femoral neck. American Journal of Roentgenology, 144(2), 343－347.

Handoll, H. H. G., & Ollivere, B. J. (2010). Interventions for treating proximal humeral fractures in adults. Cochrane Database of Systematic Reviews, 12, Art. No.: CD000434. doi:10.1002/14651858.CD000434.pub2

Kane, R. S., & Goodwin, J. S. (1991). Spontaneous fractures of the long bones in nursing home patients. The American Journal of Medicine, 90(1), 263－266. doi:10.1016/0002- 9343(91)90553-A

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臨床的隱憂─住院病人之自發性骨折

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