There are many questions about the Registry sites and as they come up, we update these answers.
Ethics & GovernanceIs ethics approval done site by site or at a state/territory level?Ethics is done at a state-wide level with a single reviewing HREC in each state/territory, except in the Northern Territory where there will be two reviewing HRECs.What approvals are required for a hospital to participate?Hospitals need to be approved by the Lead HREC in their state or territory and then they require a site Governance approval before being able to contribute data to the registry. For hospitals in Queensland, there are also applications under the Public Health Act required.Is there an explanatory leaflet for us to give to the patients/family?Yes. The Project Information Pamphlet is to be given to patients and their family or carer. These will be provided to sites as part of the Ethics and Governance approval process.
Data Collection – AdmissionWhich patients are eligible to be included in the ANZHFR?Men and women aged 50 years and over admitted to hospital for management of a fractured proximal femur.Does the registry include periprosthetic fractures or is it only for people with a primary hip fracture?The registry records only primary hip fracture. However, if the person is included in the registry for a primary fracture and sustains a periprosthetic fracture as a complication of treatment, the periprosthetic fracture would be included in the data captured at 30 or 120 days if it required re-operation.What happens if a person presents to a hospital without imaging facilities and is then transferred to a hospital for imaging and then transferred to a third hospital for treatment. Which of the first or second hospitals is the transfer hospital?The transfer hospital is the first hospital the person presented to.A patient has an undiagnosed #NOF on admission and is admitted to a medical unit. They are seen by the Orthopaedic team days later. X-rays taken earlier support a diagnosis of #NOF. From when is delay to the operating theatre measured? And what is the date/time of diagnosis?Both are measured from the time of diagnosis.Can the preferred ward be an infection control ward?Yes if it is because they have an infection (eg MRSA) and it is an appropriate admission to an infection control ward. It would be recorded as the “preferred ward”. If the admission to the ward is because it is the only place a bed can be found then it would be recorded as an “outlying ward”.
Data Collection – Assessment
These questions relate to the Data Collection – Assessment aspects of the registry.
Our hospital doesn't do an AMT Score. In terms of cognition screening we preform the RUDAS (Rowlands universal dementia assessment screen), or the ACE3 (Addenbrookes cognition examination) and I'm wondering how I can enter that into the data base because it doesn't exactly match up with the scores that are provided for the AMT score.Leave the field blank. This field will be reviewed in 2016 to reflect appropriate cognitive screening tools.
Data Collection – Treatment
These questions relate to the Data Collection – Treatment aspects of the registry.
How much data is entered for patients who are not treated by surgery? And are they followed up at 30 and 120 days?Patients managed conservatively have all available data fields completed and are also followed up at 30 and 120 days. Data fields relating to surgery are “hidden” by the registry.Is a nerve block recorded in the Anaesthesia data field or solely in the Analgesia data field if it was performed preoperatively?The nerve block will be recorded in the Analgesia data field.The patient was given a combination of a general anaesthetic and a femoral nerve block in the operating theatre. How is this recorded?General is the Anaesthesia and femoral nerve block is the Analgesia.How are combination anaesthetics recorded in the database? Eg an anaesthetic which combines general and spinal.Combination anaesthesia would be recorded as ‘Other’.Is the Queensland Health Falls Assessment and Management Plan enough to qualify for a specialist falls assessment as per the ANZHFR data field?.No. This is a standard screen for risk of falls in hospital and doesn’t replace a specialised falls assessment. The Data Dictionary has a definition of what qualifies as a specialist falls assessment.The patient is given the opportunity to mobilise on day 1, but didn't due to a patient dependant reason. Must the patient get out of bed or just be given the opportunity to mobilise?This would be recorded as given the opportunity to mobilise.How is 'bone protection medication at discharge' recorded if medication has been prescribed but not commenced at discharge?If the person has been discharged before commencing the medication, data will be recorded as “no bone protection medication”. Documentation that the medication is recommended does not satisfy requirements for medication having commenced at discharge. If they are recommencing a previously prescribed medication prior to discharge then it would be recorded as “yes” in the relevant category.Most of our patients are discharged with a recommendation for bispohosphonate (oral or IV) strontium, denosumab or teriparitide (with or without calcium and/or vitamin D) to commence at 3 months. How is this recorded?A recommendation that has been acted on after discharge will be captured at the 30-day and/or 120-day follow up.
Data Collection – Discharge
These questions relate to the Data Collection – Discharge.A person is discharged with HITH (Hospital In The Home) services. How is the discharge status recorded?The option that best describes the environment in which the service is provided. It is most likely to be the “private residence”.How do I record the date of discharge from the acute / orthopaedic ward? The patient may be discharged to rehabilitation however wait several days to be transferred because there are no available beds, or they are statistically 'type changed'.The acute ward / orthopaedic ward discharge date is the date the person physically leaves the bed. It does not relate to a discharge based on a coding change.How do I record the date of final discharge from hospital system?If the patient leaves the hospital directly from the acute ward then the date recorded is the same as the acute / orthopaedic ward discharge date. If the patient is transferred to rehabilitation, then the date they leave from rehabilitation is the date recorded. If the patient is transferred to rehabilitation outside your hospital campus/health district, it may not be possible to determine the date they leave the hospital system. In this case the date is left blank.