Background
Hip fracture is a common occurrence in older adults, resulting in over 4,000 hospital admissions each year in Ireland. Hip fracture in older adults is associated with poor outcomes, such as high rates of mortality within the 12-months, and with many survivors failing to regain their previous levels of functional independence. Post-operative inpatient rehabilitation following hip fracture, delivered by a multidisciplinary team, has been shown to result in fewer cases of a poor outcome (e.g., death or new admission to residential care). Accelerated or early supported discharge (ESD) from hospital after hip fracture offers multidisciplinary rehabilitation delivered in the home environment that would otherwise be delivered in the inpatient setting. ESD after hip fracture is recommended by several healthcare regions for medically stable older adults who can transfer and mobilise over short distances and who would benefit from further rehabilitation. ESD has been shown to reduce hospital length of stay for older adults following hip fracture.
Aim
This mixed methods systematic review aims to synthesise the empirical evidence regarding barriers and facilitators to implementation of ESD for older adults after hip fracture.
Methods
This systematic review will be conducted in accordance with the Joanna Briggs (JBI) methodology for mixed methods systematic review. MEDLINE Ovid, EMBASE (EBSCO Host), CINAHL (EBSCO Host), PsycINFO (EBSCO Host), and the Cochrane Library (Wiley) will be electronically searched for qualitative, quantitative, or mixed methods studies investigating barriers and facilitators to ESD implementation. Grey literature will be searched and considered for inclusion. The JBI standardised tools will be used to guide critical appraisal and data extraction. A convergent integrated approach, incorporating qualitative findings and transformed quantitative data, will be utilised.
Conclusion
This review will provide a comprehensive understanding of factors that affect the implementation of ESD for older adults following hip fracture.