1. Nurs Older People. 2014 Nov 28
Neighbour C.
Author information: Musculoskeletal and Neurosciences Directorate, Nottingham University Hospitals
NHS Trust.
Constipation is a common problem in older people with hip fracture because of
immobility, opioid prescription and lack of privacy. There is a dearth of
meaningful evidence about the way constipation is recognised and its subsequent
treatment. The orthogeriatric team in a university hospital trust investigated
the effectiveness of bowel care for older inpatients after hip fracture. Three
audits followed a cohort of 40 people aged 60 and older after surgical fixation
of hip fracture. After the initial audit in 2010, the expectation was that all
hip fracture patients should be started on laxatives on the day of surgery and a
chart used to document stool type. Nursing and medical staff needed to ensure
that adequate pain control was maintained while opiate analgesia was given only
when necessary. Patients with hip fracture are now significantly less
constipated. There is improved patient satisfaction with analgesia provision.
While laxative prescription is important, a motivated ward team encouraging its
uptake is vital. All patients now have a comprehensive record of bowel movements.
The improvements demonstrate the importance of a multidisciplinary approach when
caring for these patients.