Whose responsibility is it anyway? The doctor? The nurse? The patient? The answer to this question about preventing hip fractures is at the heart of our program. Break Free proposes the establishment of a Fracture Liaison Nurse, a team member whose position is part traffic cop, part educator and full-time facilitator in owning fracture prevention. The person in this very important position is charged with ensuring what we call “The 3 i’s”.
When the patient comes into the clinic or hospital with an initial fragility fracture, he or she is identified as a potential candidate for a future hip fracture. They learn about the risk of having a future hip fracture.
After education comes bone density testing, blood tests and falls risk assessment to profile all known factors contributing to the patient’s fracture risk. Using the history and test results, the Fracture Liaison Nurse can then calculate the Risk Level for future fracture using a proven algorithm.
The Fracture Liaison Nurse works with the doctor and the patient to start the patient on a course of preventative therapy to lower the risk of a devastating hip fracture. Based on the future fracture risk, an evidence-based treatment plan is customized for the patient. This can range from simple Vitamin D supplementation and education, to falls prevention training – all the way to bone-building medication for the highest risk patients. The success of our new program is all about follow-up. No one falls through the cracks because it was assumed to be someone else’s responsibility.