NURSING INTERVENTIONS IN THE MANAGEMENT OF PAIN IN ELDERLY PEOPLE WITH HIP FRACTURE.

Abstract

Introduction: Older adults with hip fracture require continuous and individualized pain management from hospital admission to rehabilitation, where Nursing plays a crucial role in the management and control of pain, so it is necessary to carry out specific interventions depending on the time of the intervention. Objective: To determine the nursing interventions in pain management in older adults with hip fracture based on scientific evidence and according to the time of the intervention (preoperative and postoperative) in the Orthogeriatrics service of the National Rehabilitation Institute "Luis Guillermo Ibarra Ibarra (LGII)”. Methodology: This is a descriptive, retrospective research, whose source of information was the nursing sheet of the clinical record of users who have been hospitalized from January to June of this year, in the Orthogeriatrics service of the National Rehabilitation Institute "LGII", with a medical diagnosis of hip fracture to receive surgical treatment and who meet the inclusion criteria. Results: The main attention of the Orthogeriatrics service of this institution focuses on the approach to hip fracture due to its high incidence, under the inclusion criteria, 62 older adults were considered, where the high prevalence of the presence of pain is highlighted, mainly acute and nociceptive type assessed through the use of the Visual Analog Scale (VAS), where the highest prevalence of cases presented an intensity of mild to moderate; As part of the dependent Nursing Interventions, there is pharmacological pain management, where the use of non-opioid non-anti-inflammatory analgesics such as paracetamol prevails, this being the initial treatment of choice. Interdependent interventions with physical therapy professionals are also performed, such as the use of physical equipment. In the immediate postoperative period, pain management is performed to initiate early rehabilitation and reduce morbidity and mortality arising from complications in major surgeries. The continued administration of analgesics is emphasized, but parenterally, with emphasis on the use of analgesic infusions through mild opioids in doses that can be progressively increased depending on the individual's response. Regarding independent interventions, postural changes are performed, which are essential to achieve pain-reducing postures that respect the biomechanical principles of osteosynthesis or hip abduction in joint replacement surgery, and the application of physical equipment (cryotherapy). Conclusions: The Nursing Interventions for pain management carried out in the Orthogeriatrics Department of INRLGII not only aim to demonstrate what is done in the service, but also to become part of a national reference in the management of older adults with hip fractures, where the implementation of non-pharmacological measures together with the administration of analgesics makes it possible to avoid polypharmacy and where early mobility is an essential component of postoperative care.