Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Cynthia Schmidt

Project Team Faculty Member

Adam Schneider

Keywords

Fascia Iliaca Block, Hip fracture, opioids, pain management, emergency department, elderly, geriatric

Abstract

Due to the aging population, the number of falls are increasing, leading to an increased number of individuals with hip fractures presenting in emergency departments (ED). Opioids are often administered for intraoperative pain related to hip fractures, which may result in a number of adverse effects, especially in the elderly. There is strong evidence suggesting that the use of fascia iliaca blocks (FIBs) in the ED can minimize opioid use, and improve patient outcomes and recovery. FIB is a compartment block that delivers local anesthetic around the lumbar plexus to provide analgesia associated with hip fractures.

The purpose of this project was to develop and create a guideline for the administration of FIB in the ED of a small rural hospital in Central Illinois. The guideline was developed in collaboration with the agency stakeholder. A face-to-face session with CRNAs was held to provide information on FIB, present the guideline, and encourage open discussion. A survey was provided to gain staff’s perceptions of the guideline and how it could be improved. Results indicated the staff strongly approved the FIB guideline and were interested in its implementation. The stakeholder plans to implement the guideline once approved by ED and orthopedic surgeons.

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