School of Nursing
Doctor of Nursing Practice (DNP)
conservative or surgical treatment, morbidity, mortality, rib fractures, older adult, surgical treatment, integrative review
Boeding, Adella Jo, "Treatment of Rib Fractures of the Elderly Patients in the Acute Care Setting: An Integrative Review" (2023). Doctoral Dissertations and Projects. 4770.
This integrative review aimed to identify best practices associated with treatment for multiple rib fractures. The clinical question is, “In patients 60 and older with multiple rib fractures, are conservative treatments more effective in reducing comorbidities and mortality than surgical treatments?” This Integrative Review was conducted using Whitemore and Kanfl’ as a framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were also used to conduct this review. Steps included problem identification, literature search with inclusion and exclusion criteria, data evaluation, data analysis through reduction and extraction, and presentation. This integrative review established that people over 65 experience longer hospital stays because they take more time to heal. In patients over 60 years, surgical treatment of multiple rib fractures could ease acute pain in the chest, lower the risks of other conditions (e.g., pneumonia), and reduce hospitalization compared to conservative treatment. Although surgical treatment was effective in treating patients with multiple rib fractures, this integrative review established that surgical treatment is costly and may increase the time patients spend in hospitals. The emergence of co-occurring injuries may limit the use of surgical treatment. Different complications, such as deep vein thrombosis and pulmonary embolisms, may occur after surgery. It is recommended that healthcare professionals increase the evaluation and screening of patients over 60 years old based on specific patient co-morbidities, demographics, and available screening tools for the best possible patient-centered outcomes.
Available for download on Friday, August 23, 2024