Orthopaedic and Trauma Nursing E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1281

Veröffentlichungsjahr: 2022

Beschreibung

Orthopaedic and Trauma Nursing A comprehensive and evidence-based manual for orthopaedic and trauma nurses and students In the newly revised second edition of Orthopaedic and Trauma Nursing: An Evidence-based Approach to Musculoskeletal Care, a team of accomplished practitioners and educators deliver a straightforward and practical textbook for the practice of neonate, infant, child, young person, adult and older person orthopaedic and trauma nursing. The book explores topics of critical importance to those working in acute wards, clinics, community hospitals, nursing homes, and patients' homes. Divided into 5 intuitive sections, this book examines central issues in orthopaedic and musculoskeletal trauma care, specialist practice issues, the care and management of common conditions, and the care of infants, children and young people. Each chapter is based on the latest research and offers practical guidance to practitioners around the world. The book also offers: * Practical explorations of topics in specialist practice, including assessment, common musculoskeletal interventions, and complications of musculoskeletal conditions and trauma * In-depth discussions of common orthopaedic conditions and their management and care, including elective orthopaedic surgery * Holistic musculoskeletal trauma care, including the principles of trauma and fracture management Perfect for pre-registration and qualified adult and children's orthopaedic nurses working in orthopaedic and musculoskeletal trauma units in hospitals and community settings, Orthopaedic and Trauma Nursing will also be of use to students seeking post-qualification education in orthopaedic nursing.

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

List of Contributors

Foreword

Preface

Part I: Key Issues in Orthopaedic and Musculoskeletal Trauma Nursing

1 An Introduction to Orthopaedic and Trauma Care

Introduction

The Changing Nature of Orthopaedic Practice over Time

Modern Orthopaedic Care

The Nature of Orthopaedic and Musculoskeletal Trauma Nursing

Mobility and Function

Public Health and Musculoskeletal Conditions and Injury

The Diverse Orthopaedic Patient

The Context of Hospital Experiences of People with an ID

The Care Journey in Different Settings

Ethical and Legal Aspects of Orthopaedic and Trauma Care

Summary

Further Reading

References

2 Evidence and Refining Practice

Introduction

Evidence‐based Practice

Hierarchies (and Quality) of Evidence

Finding Evidence

Using Evidence in Practice: An Example

Translation of Evidence

Further Reading

References

3 Professional Development, Competence and Education

Introduction

Continuing Professional Development

Mentors

Competence

Orthopaedic and Trauma Practitioner Competences

Social Media

Reflection

Education

Summary

Further Reading

References

4 The Musculoskeletal System and Human Movement

Introduction

Anatomical Positioning

Anatomical Terminology and Movement

The Skeleton

Bone Physiology

Bone Growth and Development

Skeletal Muscle

Skeletal Muscle Attachment

Ligaments, Tendons and Cartilage

Neurovascular Supply

Joints

The Cranium (the Skull)

The Spine

The Vertebrae

Soft Tissues of the Spine

The Spinal Cord and Spinal/Vertebral Nerves

The Upper Limb

The Pelvis

The Lower Limb

Conclusion

Further Reading

References

5 The Team Approach and Nursing Roles in Orthopaedic and Musculoskeletal Trauma Care

Introduction

The Team and Importance of a Multidisciplinary Approach

Team Roles

Nursing Roles in Orthopaedic and Trauma Care

Medical Roles in Orthopaedic and Trauma Care

Allied Health Professional Roles in Orthopaedic and Trauma Care

Additional Supporting Team Members

Conclusion

Further Reading

References

6 Rehabilitation and the Orthopaedic and Musculoskeletal Trauma Patient

Introduction

History and Context of Rehabilitation

Prehabilitation

Models of Care

The Rehabilitation Process

Assessment

Goal Setting

Developing an Implementation Plan and Evaluation

Team Approaches to Rehabilitation

The Role of the Nurse

Psychological Support in Rehabilitation

Trauma and Orthopaedic Conditions Requiring Rehabilitation

Rehabilitation Settings

The Use of Technology to Support Rehabilitation

Summary

Further Reading

References

Part II: Specialist and Advanced Practice

7 Clinical Assessment of the Orthopaedic and Trauma Patient

Introduction

Principles of Clinical Assessment

Models and Frameworks of Patient Assessment

The Medical Model

Assessing the Impact of Disease on the Individual

Assessing Cognitive Function

Assessing Risk

Patient Assessment Using Telemedicine

Summary

Further Reading

References

8 Key Musculoskeletal Interventions

Introduction

The Principles of Casting

Casting Technique

Cast Complications

Living with a Cast

Cast Removal, Splitting and Bi‐valving

Orthotics, Braces, Prosthetics and Appliances

External Fixation and Pin Site Care

Types of Fixator

Biomechanics

Complications

Nursing Care

Mobilising

Work

Sleeping

Sexual Activity

Pin Site Wounds

Pin Site Infection

Contemporary Traction

Principles of Traction

Methods of Application

Principles of Applying Traction

Mechanics of Traction

Care of Traction

Common Types of Traction

Further Reading

References

9 The Complications of Musculoskeletal Conditions and Trauma

Introduction

Infection

Surgical Site Infection

Urinary Tract Infection

Respiratory Tract Infection (Pneumonia)

Sepsis and Septic Shock

Shock

Hypovolaemic Shock

Venous Thromboembolism

Fat Embolism Syndrome

Acute Compartment Syndrome

Neurovascular Assessment

Urinary Retention

Constipation

Further Reading

References

10 Nutrition and Hydration

Introduction

Diet and Musculoskeletal Health

Metabolic Response to Trauma, Surgery and Other Issues

Nutrition Assessment and Intervention

Hydration and Dehydration: Assessment and Intervention

Summary

References

11 Pain Assessment and Management in Orthopaedic and Trauma Care

Introduction

The Nature of Pain

The Gate Control Theory of Pain

Peripheral Sensitisation

Spinal Modulation

Central Modulation

Conscious Recognition

Physiological Effects of Acute Pain

Types of Pain

Pain Assessment

Formal Pain Assessment

Successful Pain Assessment

Pain Management

Pain Management Interventions at the Site of Trauma

Pain Management Interventions to Block Onwards Transmission

Pain Management Interventions to Affect Conscious Recognition

Systemic Analgesia

Summary

Further Reading

References

Online Resources

12 Wound Management, Tissue Viability and Infection

Introduction

Wound Management

Traumatic Wounds

The Wound‐healing Process

Factors Affecting Wound Healing

Moist Wound Healing

Permeability and Transparency

Ability to Act as a Bacterial Barrier

Bathing and Showering

Ease of Removal

Wound Assessment

Wound Measurement

Wound Bed

Surgical Site Infection

Preventing SSI

Recognising SSI

Pressure Ulcers

Classification of Pressure Ulcers

Pressure Ulcer Formation

Superficial Ulceration

Deep Ulceration

Preventative Care

Turning

30° Tilting Regime

Pillows

Collars

Heel Splints

Alternating Support Surfaces

Pressure‐reducing Support Surfaces (Constant Low‐pressure Devices)

Management of Pressure Ulcers

Further Reading

References

Part III: Common Orthopaedic Conditions and their Care and Management

13 Key Conditions and Principles of Orthopaedic Management

Introduction

Osteoarthritis

Spondyloarthropathies

Rheumatoid Arthritis

Osteoporosis

Paget’s Disease

Osteomyelitis

Back Pain

Scoliosis

Spinal Stenosis

Intervertebral Disc Disease

Juvenile Idiopathic Arthritis: An Outline

Summary

Further Reading

References

14 Elective Orthopaedic Surgery

Introduction

Principles of Care

Common Types of Orthopaedic Surgery

Shoulder Arthroplasty

Spinal Surgery

Pre‐operative Care

Post‐operative Care

Discharge Planning/Rehabilitation

Patient Education/Health Promotion

Summary

Further Reading and Resources

References

15 Musculoskeletal Oncology over the Lifespan

Introduction

Bone Sarcoma

Treatments

Osteosarcoma

Ewing's Sarcoma

Chondrosarcoma

Soft Tissue Sarcoma

Metastatic Bone Disease

Clinical Trials

Nursing and Psychological Care

The Role of Specialist Nursing

Sarcoma Follow‐up

Palliative Care

Summary

Further Reading

References

Part IV: Musculoskeletal Trauma Care

16 Principles of Trauma Care

Introduction

Pre‐hospital Care

Primary Survey

Secondary Survey

Musculoskeletal Assessment

Severe Injury and Polytrauma

Rhabdomyolysis

Monitoring, Deterioration and Early‐warning Scores

Early‐warning Scores and the Deteriorating Patient

Summary

Further Reading

References

17 Principles of Fracture Management

Introduction

Causes and Types of Fractures

Describing Fractures

Fracture Repair

Assessment and Emergency Care

The Complications of Fractures

Management of Fractures

Facilitating Fracture Healing

Open Fractures

Management of Common Fracture Types

Evidence‐based Practise in Fracture Care and Outcomes

Summary

Further Reading

References

18 Fragility Fractures

Introduction

Fragility Fractures

Osteoporosis

Secondary Fracture Prevention Services

Falls

Frailty and Sarcopenia

Conclusion

Further Reading

References

19 Fragility Hip Fracture

Introduction

Orthogeriatric Nursing

Fragility Hip Fracture

Orthogeriatric Nursing Competencies

Rehabilitation of the Older Person Following Hip Fracture

Palliative and End‐of‐life Care for Patients Following Hip Fracture

Ethical Considerations in Treatment of Patients with Hip Fracture

Hip Fracture Audit

Conclusion

Further Reading

Resources

References

20 Spinal Cord Injury

Introduction

Patterns of Injury

Anatomical Considerations

Pathophysiology of the Injury

Emergency Care and Management

Subsequent Care and Rehabilitation

Bowel Management

Spasm

Pain

Post‐injury Complications

Conclusion

Further Reading

References

21 Soft Tissue, Peripheral Nerve and Brachial Plexus Injury

Introduction

Soft Tissue Injuries

Nerve Injuries

Brachial Plexus Injuries

Further Reading

References

Part V: Children and Young People

22 Key Issues in Caring for the Child or Young Person with an Orthopaedic or Musculoskeletal Trauma Condition

Introduction

Age Definitions

The Care Environment

The Team

Planning Care

Consent and Capacity

Pain

Safeguarding Children: Everybody's Business

Assessment for Non‐accidental Injury

Role and Responsibilities of Practitioners

Summary

Further Reading

References

23 Common Childhood Orthopaedic Conditions, Their Care and Management

Introduction

Musculoskeletal Assessment

Normal Variants

Common Conditions Presenting in the Neonate, Infant, Child and Young Person

Legg Calvé Perthes Disease

Slipped Capital Femoral Epiphysis

Vitamin D Deficiency

Congenital Talipes Equino Varus

Amplified Musculoskeletal Pain Syndrome

Further Reading

References

24 Fracture Management in the Infant, Child and Young Person

Introduction

Key Stages of Musculoskeletal Development of Bone and Fracture Healing

Specific Conditions and Fractures Presenting in Children

Fracture Diagnosis, Classification and Management in Childhood

Fractures Unique to Childhood

Main Principles of Fracture Treatment

Further Reading

References

25 Key Fractures Relating to the Infant, Child and Young Person

Introduction

Physeal Injuries

Upper Limb Injuries

Lower Extremity Fractures

Spinal Cord Injury

Non‐accidental Injury

Summary

Further Reading

References

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Age groups in relation to orthopaedic problems

Chapter 2

Table 2.1 Research summary

Table 2.2 Literature summary

Table 2.3 Research matrix template

Table 2.4 Literature matrix template

Chapter 4

Table 4.1 Bone classifications.

Table 4.2 Bone tissue cell types.

Table 4.3 The function of the bones of the skull.

Table 4.4 The characteristics of vertebrae.

Table 4.5 The ligaments of the spine.

Chapter 6

Table 6.1 Description and summary of key differences between multidisciplina...

Table 6.2 Body concepts (Price 1990)

Chapter 7

Table 7.1 Types of subjective and objective data

Table 7.2 Review of systems

Chapter 8

Table 8.1 The functions of casts.

Table 8.2 Types of casting materials.

Table 8.3 Complications of casts.

Chapter 9

Table 9.1 ATLS® classification of hypovolaemic shock (American College of Su...

Chapter 10

Table 10.1 Daily recommended intake of calcium in healthy subjects (National...

Table 10.2 Daily recommended intake of calcium (British Dietetic Association...

Table 10.3 Body mass index, WHO classification.

Table 10.4 Recommended daily fluid intake for children.

Chapter 11

Table 11.1 Harmful effects of unrelieved pain

Table 11.2 Relative efficacy of commonly used analgesics

Chapter 12

Table 12.1 Factors and conditions affecting wound healing.

Table 12.2 Wound history questions for wound assessment.

Table 12.3 Wound bed assessment: tissue colour.

Table 12.4 Signs of surgical site infection which should be considered as pa...

Chapter 13

Table 13.1 Other spondyloarthropathies.

Table 13.2 Psoriatic arthritis treatment toolbox.

Table 13.3 The Disease Activity Score (DAS28) for the assessment of rheumato...

Table 13.4 Biologic therapies and licencing indications.

Table 13.5 Licensed indications for JAK inhibitors.

Chapter 14

Table 14.1 Recommendations for all types of surgery

Table 14.2 Example of investigations required for patient ASA Grade 3 underg...

Chapter 17

Table 17.1 Craig's system for fracture management.

Table 17.2 Craig's system for fracture management in wrist fractures.

Table 17.3 Craig's system for fracture management in ankle fractures.

Table 17.4 Gustilo–Anderson classification system for compound fractures. Ad...

Chapter 18

Table 18.1 Categories of risk factors and examples

Chapter 19

Table 19.1 Additional considerations for older people in the primary survey....

Table 19.2 Predisposing and precipitating factors for delirium (Meehan et a...

Chapter 20

Table 20.1 Summary of respiratory function dependant on level of SCI.

Table 20.2 Example of a daily bowel management routine.

Chapter 21

Table 21.1 The origins of the main peripheral nerves of the arm.

Table 21.2 MRC scale for assessment of muscle power.

Chapter 23

Table 23.1 An example surgical programme.

Chapter 24

Table 24.1 Traction type and injury

Chapter 25

Table 25.1 Options for treatment of femoral shaft fractures (Lindisfarne and...

List of Illustrations

Chapter 4

Figure 4.1 Anatomical position.

Figure 4.2 Planes of the body.

Figure 4.3 Haversian system (osteon).

Figure 4.4 Types of synovial joint.

Figure 4.5 The spine.

Figure 4.6 Structure of a typical vertebrae (illustrated by a thoracic verte...

Figure 4.7 Intervertebral discs.

Figure 4.8 Spinal cord and spinal nerves.

Figure 4.9 Right upper limb.

Figure 4.10 The female pelvis – anterior view.

Figure 4.11 Lower limb – hip to knee.

Figure 4.12 Lower limb – knee to foot.

Chapter 8

Figure 8.1 Hoffman (monolateral) external fixator frame.

Figure 8.2 Taylor spatial (circular) frame.

Figure 8.3 Fixed skin traction with a Thomas splint.

Figure 8.4 Skin traction.

Figure 8.5 Hamilton Russell traction.

Figure 8.6 Bryants/Gallows traction.

Figure 8.7 Balanced Thomas splint traction with Pearson attachment.

Figure 8.8 Dunlop traction.

Chapter 11

Figure 11.1 Gate control theory of pain.

Chapter 12

Figure 12.1 Heel pressure ulcer with necrosis and hard, black eschar.

Figure 12.2 Wound containing overgranulation tissue.

Figure 12.3 Pressure ulcer containing slough.

Figure 12.4 Performing the 30° tilt.

Chapter 13

Figure 13.1 Holistic assessment of a person with osteoarthritis (OA).

Chapter 14

Figure 14.1 Surgical checklist.

Chapter 15

Figure 15.1 MRI scan showing soft tissue sarcoma of the upper arm.

Figure 15.2 X‐ray showing pathological fracture of the distal femur.

Figure 15.3 Fluoroscopic guided biopsy of a chondrosarcoma of the distal hum...

Figure 15.4 CT scan of the chest showing metastatic osteosarcoma.

Figure 15.5 X‐ray showing chondrosarcoma of the proximal humerus.

Figure 15.6 MRI scan of liposarcoma of the thigh.

Figure 15.7 Metastatic renal cell carcinoma of the proximal humerus.

Chapter 16

Figure 16.1 The chain of O

2

delivery.

Figure 16.2 Insertion of a Guedal airway.

Figure 16.3 Maintaining an airway.

Figure 16.4 The haemorrhaging trauma patient.

Figure 16.5 Performing a safe log roll.

Figure 16.6 Example of an early warning score assessment sheet.

Chapter 17

Figure 17.1 Examples of types of fractures.

Figure 17.2 The process of fracture repair.

Chapter 18

Figure 18.1 Fracture morbidity.

Chapter 19

Figure 19.1 Classification of hip fracture.

Figure 19.2 The blood supply to the head and neck of femur.

Figure 19.3 Examples of disruption of the blood supply to the head and neck ...

Figure 19.4 Hemiarthroplasty.

Figure 19.5 Total hip replacement.

Figure 19.6 Dynamic hip screw.

Figure 19.7 Proximal femoral nail.

Figure 19.8 DoMAP model: Determinants of malnutrition in aged persons.

Chapter 20

Figure 20.1 American Spinal Injuries Association Impairment Scale (2019)....

Chapter 21

Figure 21.1 The brachial plexus.

Figure 21.2 ASIA scale.

Chapter 22

Figure 22.1 Spica cast/hip spica in human position.

Chapter 23

Figure 23.1 Genu valgum.

Figure 23.2 Hip ultrasound showing a dysplastic hip.

Figure 23.3 X‐ray showing a dislocated left hip: the ossific nucleus is abse...

Figure 23.4 Pavlik harness.

Figure 23.5 X‐ray showing a pelvic osteotomy – the graft is secured with pin...

Figure 23.6 X‐ray showing Perthes disease of the left hip – note the collaps...

Figure 23.7 X‐ray showing shelf acetabuloplasty of the left hip.

Figure 23.8 X‐ray showing slipped left femoral capital epiphysis where Klein...

Figure 23.9 X‐ray showing slipped left femoral capital epiphysis, fixed with...

Figure 23.10 Wrist X‐ray showing widened and cupped physis.

Figure 23.11 X‐ray showing rickets.

Figure 23.12 Club foot (congenital talipes equino varus).

Figure 23.13 Pirani score.

Figure 23.14 Ponseti cast.

Figure 23.15 Boot on a bar. NHS, https://www.nhs.uk/conditions/club‐foot/.

Chapter 24

Figure 24.1 Series of child hip X‐rays from birth to skeletal maturity: (a) ...

Figure 24.2 Series of X‐rays to show fracture remodelling in a femur: (a) ne...

Figure 24.3 Types of fracture.

Figure 24.4 Bone descriptors applied to the femur.

Chapter 25

Figure 25.1 Salter Harris type 1 displaced fracture through the inferior tib...

Figure 25.2 Fracture of distal radius Salter Harris type II fracture with sl...

Figure 25.3 Fracture of the mid clavicle with slight angulation in a 2‐year‐...

Figure 25.4 Supracondylar fracture of the distal right humerus with signific...

Figure 25.5 Supracondylar fracture of the distal left humerus with gross def...

Figure 25.6 Deformity through the proximal radial metaphysis with gross disp...

Figure 25.7 Distal radius and ulna buckle fracture without significant defor...

Figure 25.8 Fractures of the palmar aspects of the proximal ends of middle p...

Figure 25.9 An ununited fracture of the mid scaphoid with no evidence of ava...

Figure 25.10 Oblique femoral mid‐shaft fracture.

Figure 25.11 An oblique/spiral distal tibial and fibula fracture with minima...

Figure 25.12 Below‐knee cast.

Figure 25.13 Fracture through the base of the fifth metatarsal.

Guide

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Orthopaedic and Trauma Nursing

An Evidence‐based Approach to Musculoskeletal Care

Second Edition

Edited by

Sonya Clarke and Mary Drozd

This second edition first published 2023© 2023 by John Wiley & Sons Ltd

Edition HistoryJohn Wiley & Sons, Ltd (1e, 2014)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

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Library of Congress Cataloging‐in‐Publication DataNames: Clarke, Sonya, editor. | Drozd, Mary, editor.Title: Orthopaedic and trauma nursing: an evidence‐based approach to musculoskeletal care / edited by Sonya Clarke and Mary Drozd.Other titles: Orthopaedic and trauma nursing (Clarke) Description: Second edition. | Hoboken, NJ: Wiley‐Blackwell, 2023. | Includes bibliographical references and index. Identifiers: LCCN 2022029474 (print) | LCCN 2022029475 (ebook) | ISBN 9781119833383 (paperback) | ISBN 9781119833390 (adobe pdf) | ISBN 9781119833406 (epub) Subjects: MESH: Orthopedic Nursing–methods | Trauma Nursing–methods | Musculoskeletal System–injuries | Wounds and Injuries–nursing | Evidence‐Based Nursing Classification: LCC RD753 (print) | LCC RD753 (ebook) | NLM WY 157.6 | DDC 616.7/0231–dc23/eng/20220819 LC record available at https://lccn.loc.gov/2022029474LC ebook record available at https://lccn.loc.gov/2022029475

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List of Contributors

Thelma Begley, MSc (Nursing), Bachelor Nursing Studies (Hons), Higher Diploma in Nursing Studies (Children's Nursing) and (Nurse Education), Orthopaedic Nursing Certificate, RGN, RCN, RNT

Assistant Professor in Children's Nursing, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland

Thelma, a nurse for over 30 years, holds qualifications in adult, child and orthopaedic nursing as well as in nurse education. Her clinical experience includes children, young people's medical and surgical nursing, and adult and children's orthopaedic nursing, in particular orthopaedic trauma. She has significant teaching experience in undergraduate and postgraduate nursing programmes, with specialist expertise teaching children's and orthopaedic nursing. She is module leader on undergraduate, postgraduate and MSc children's nursing programmes.

Dr Sonya Clarke (Editor) , EdD, MSc, PGCE (Higher Education), PG Cert (Pain Management), BSc (Hons) Specialist Practitioner in Orthopaedic Nursing, RN child, RGN

Senior Lecturer (Education), School of Nursing & Midwifery, Queen's University Belfast, Belfast, UK

Sonya, a nurse for over 30 years, has experience in children's and adult nursing in her nursing career, which commenced in 1988. She qualified as an RGN in 1991, followed by a diploma in Children's Nursing in 1996. Clinical practice was primarily within Northern Ireland's regional elective orthopaedic unit for the adult and child until 2001, with additional nursing experience (bank position) gained as a Marie Currie nurse until 2009. Prior to her teaching position in 2003, she was employed as a Lecturer Practitioner at Queen's University Belfast and Musgrave Park Hospital, Belfast. Current positions within higher education include Professional Lead for a new MSc pre‐registration in Children's and Young People's Nursing and established pathway leader within continuing professional for a short course in Orthopaedic and Fracture Trauma Nursing across the Lifespan. Sonya's teaching, research and scholarly activity reflects both children's nursing (child rights) and her specialist subject area of orthopaedics. Sonya was presented with the Royal College of Nursing (RCN) Award of Merit in 2020, the highest honour for service in recognition of the exceptional contribution she has made to the RCN. She also has an extensive publication history and continues to actively lead, inspire and deliver evidenced‐based education that motivates and advances nursing.

Alison Collins, BSc (Hons), RGN, District Nursing Qualification Certificate in Orthopaedic Nursing, Post Grad Dip in Wound Healing and Tissue Repair, MSc

Tissue Viability Nurse, Belfast Health & Social Care Trust, Belfast, UK

Alison is an experienced nurse of more than 25 years. She currently holds a specialist nursing post within the largest health and social care trust within Northern Ireland.

Yvonne Conway, MSc Primary Care, BSc (Hons) Nursing, logy, Adv Dip Ed, RGN, RNT

Department of Nursing, Health Sciences and Integrated Care, Atlantic Technological University (Mayo), Castlebar, Ireland

Yvonne has extensive experience of teaching and curriculum development in both undergraduate and postgraduate general nursing. Her clinical expertise lies principally in emergency nursing, having worked in both UK emergency departments and USA trauma centres before her move into nurse education. She has directed Master's programmes in emergency nursing and acute medicine, and was a Trauma Nursing Core Course instructor. She has presented at conferences nationally and internationally, and been involved in funded research projects covering various topics. Recent publications include a rapid systematic review and qualitative evidence synthesis.

Dr Stefanie Cormack, PhD, MSc, PGCAPHE, FHEA

Senior Lecturer, Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK

Stef is a Senior Lecturer and research lead for paramedic science for the Faculty of Education, Health and Wellbeing at the University of Wolverhampton. She qualified as a paramedic and worked as an operational helicopter emergency medical service (HEMS) critical care paramedic, gaining her Master's degree before moving into paramedic education. She has research interests in out‐of‐hospital cardiac arrest management, human factors and prehospital trauma/HEMS. Her PhD was a mixed methods approach to designing and evaluating a behavioural marker system for paramedic non‐technical skills when managing an out‐of‐hospital cardiac arrest.

Mrs Julie Craig, MB BCh BAO (Hons.), MSc (Clin. Ed), MRCS MSc (Ortho. Eng.)

Orthopaedic Specialty Doctor, Royal Victoria Hospital, Belfast Health & Social Care Trust, Belfast, UK

Julie Craig is an orthopaedic specialty doctor in the Royal Victoria Hospital, Northern Ireland's regional trauma centre, in the Belfast Health & Social Care Trust (BHSCT). Julie graduated as a doctor from Queen's University Belfast (QUB) and is a member of the Royal College of Surgeons of Edinburgh. She has completed a Master's degree in clinical education at QUB and a Master's degree in orthopaedic engineering at Cardiff University. She is the former undergraduate medical educational lead for fractures in BHSCT, and currently teaches quality improvement and leadership skills to doctors in BHSCT and teaches postgraduate nurses specialising in trauma and orthopaedics. She has a special interest in clinical data analysis, is the specialty improvement lead for the BHSCT trauma database, and is a member of the Royal College of Physician's Falls and Fragility Fracture Audit Programme (FFFAP) board and the National Hip Fracture Database Advisory Group. She has presented her work on the Royal Victoria Hospital's fracture and major trauma patients internationally and has been the recipient of the prizes for best presentations from the British Trauma Society, the Irish Hip Fracture Database Annual Meeting and the British Orthopaedic Association (Bone and Joint Journal Prize).

Peter Davis MBE, Cert.Ed, BEd (Hons), RGN, DN, ONC, MA

Associate Professor (retired), Emeritus Editor International Journal of Orthopaedic and Trauma Nursing

During the late 1980s, Peter held posts in pre‐ and post‐basic nursing education with a specific remit for orthopaedic nurse education. In 1989, he gained a Master's degree in nursing and education. In 1994, his first book, as editor and contributor, was published, Nursing the Orthopaedic Patient. From 1992 to 1994, he was chair of the RCN Society of Orthopaedic and Trauma Nursing, and he has spent several years as a committee member. He was founding editor of the Journal of Orthopaedic Nursing and is now Emeritus Editor of the new International Journal of Orthopaedic & Trauma Nursing. He has presented numerous papers at national and international conferences. A personal philosophy of practice being primary to theory has kept him close to nursing care throughout his career and ensures an emphasis on research utilisation and evidence‐based practice. In 2000, Her Majesty Queen Elizabeth II conferred on him the honour of Member of the Order of the British Empire (MBE) for services to orthopaedic nursing.

Dr Jeannie Donnelly, PhD, Dip. Wound Healing & Tissue Repair, BSc (Hon's) Health Studies incorporating the RCN Nurse Practitioner Professional Award, RN, ONC

Lead Nurse Tissue Viability, Belfast Health & Social Care Trust, Honorary Senior Lecturer, School of Nursing, Queens University Belfast, Belfast, UK

Jeannie qualified as a Registered Nurse in Belfast in 1988 and spent the first 8 years of her career working in the Fracture Trauma Unit of the Royal Victoria Hospital. During her time in this specialty, she became passionately interested in wound healing and tissue repair. In 1996, Jeannie became the first Tissue Viability Nurse on the island of Ireland, and in 2010, the Lead Nurse for Tissue Viability within the Belfast Health & Social Care Trust.

Dr Mary Drozd, Senior Teaching Fellow, Aston Medical School, Aston University, England, UK

Registered Nurse, Doctorate in Health and Wellbeing, MSc Health Sciences, BA (Hons), PGCE (Higher Education), ENB 219, Senior Fellow of the Higher Education Academy

Mary is a Registered Nurse with over 30 years' experience in orthopaedic and trauma nursing. She has worked as a staff nurse, sister, ward manager and advanced nurse practitioner in a variety of orthopaedic and trauma settings prior to joining a Higher Educational Institute in 2004. She has maintained strong clinical links alongside contributing to National Institute for Health and Care Excellence (NICE) guidance as a clinical specialist.

As an elected national steering committee member for the Royal College of Nursing (RCN) Society of Orthopaedic and Trauma Nurses (SOTN) from 2009‐ 2013 and re‐elected in 2013‐2017, Mary led the revision and further development of the RCN SOTN national competences for orthopaedic and trauma practitioners in 2012 and more recently was on the working group which published the current national competences in 2019.

Mary successfully completed a Professional Doctorate in Health and Wellbeing in 2019. Her research focused on adults with intellectual disabilities and their experiences of orthopaedic and trauma hospital care. The findings from the study have been disseminated via national and international conferences and papers from her thesis have been published in peer‐reviewed and open access journals.

Mary has undertaken the role of Book Review Editor, Assistant Editor and is currently the Social Media Editor and a peer reviewer of manuscripts for the International Journal of Orthopaedic and Trauma Nursing. In 2021, Mary was awarded Senior Fellowship of the Higher Education Academy

Professor Sandra Flynn, PhD, MSc, BA (Hons), PGCE, RN, ONC

Chester Medical School, University of Chester

Professor Flynn qualified at the Chester District School of Nursing, the Robert Jones and Agnes Hunt Orthopaedic Hospital Oswestry and the University of Liverpool in general nursing, orthopaedic and trauma nursing, and education. Sandra started her academic career as a senior lecturer at the University of Chester in 2018 and is responsible for leading on the Doctor of Medicine programme at Chester Medical School. Both her Master's and PhD are orthopaedic based. Sandra worked for the National Health Service (NHS) for 38 years, during which time she advanced her knowledge, skills and expertise in the field of trauma and orthopaedics. She held the title of Consultant Nurse in Orthopaedics at the Countess of Chester NHS Foundation Trust. Introduced in 2008, this was the first consultant nurse post in the country working within this field of practice. Sandra undertook clinical practice at an advanced level and exercised higher levels of judgement, discretion and decision making in clinical care using an advanced practice competency framework. She was one of only two nurses at that time trained to perform hand surgery in the UK. She functioned as an expert resource‐providing consultancy both internal and external to the Trust in the field of orthopaedics, monitoring and improving standards of care through clinical audit, dissemination of research, supervision of practice, teaching and provision of support for professional colleagues. Sandra is a former member of the Royal College of Nursing Society of Orthopaedics and Trauma Nursing committee, acting as Nursing Advisor to the Department of Health workforce planning sub‐group, 18‐week orthopaedic pathway. She has worked as a Specialist Advisor to the Care Quality Commission (CQC), the independent regulator of health and social care in England. Her role with the CQC was to undertake inspections of acute hospital trusts to check the quality of the orthopaedic and trauma services they provide.

Beverley Gray Linnecor, MSc Advanced Practice, BSc (Hons) Nursing Studies, PgCert TLHE, RGN, ONC, Dip CN, Cert in CBT, Cert in Counselling Skills, Professional Cert in Management

Beverley has many years of experience in both trauma and elective orthopaedic nursing. She was formerly the Clinical Nurse Specialist for the Scottish National Brachial Plexus Injury Service and Specialist Lecturer in Orthopaedics at the University of the West of Scotland. Beverley has presented papers internationally and published for books and journals. Beverley is now based in Guernsey, Channel Islands and is currently Clinical Editor with the International Journal of Orthopaedic and Trauma Nursing.

Sinead Hahessy, RGN, BA, MA (Soc. Sc.)

Lecturer and Postgraduate Programme Director, School of Nursing & Midwifery, National University of Ireland, Galway, Ireland

Sinead has 20 years' experience as a lecturer in nurse education. Her clinical nursing career includes experience in orthopaedics, gerontology, emergency care and theatre nursing. With a postgraduate background in sociology, she has contributed to the professional and educational development of undergraduate and postgraduate nursing in Ireland through involvement in curriculum design and teaching. Her teaching and research interests are in qualitative research, orthopaedic/theatre nursing, professional development in nursing and academic practice, reflective practice and arts‐based pedagogy.

Fiona Heaney, RGN, MHSc (Nursing/Education), PG Diploma (Nursing Studies/Orthopaedics), PG Diploma (Clinical Teaching)

Clinical Nurse Specialist in Bone Health Galway University Hospitals, Galway, Ireland

Fiona started out working in orthopaedic trauma and has been involved in the care of patients following fracture for over 20 years. She worked as Clinical Facilitator/Practice Development Co‐ordinator for Orthopaedic Nursing in Galway University Hospitals and later transferred into the role of Clinical Nurse Specialist in Orthopaedic Trauma. During her time working with people following acute fractures she developed an interest in promoting bone health and fracture prevention. She currently works as Clinical Nurse Specialist in Bone Health and is part of the Fracture Liaison Service in Merlin Park Hospital Galway.

Karen Hertz, MSc, BSc, DPSN, RGN, ENB219

Advanced Nurse Practitioner, Royal Stoke University Hospital, University Hospitals of North Midlands, Stoke‐on‐Trent, UK

Karen is a registered nurse, working in the National Health Service as an advanced nurse practitioner in a trauma and orthopaedic unit. She qualified in 1987 and since then has worked for 35 years in a variety of roles in trauma and orthopaedics, but her passion is for fragility fracture nursing and interdisciplinary care. She has been actively involved in both the Global and National Fragility Fracture Networks (FFNs) since their inception. She is currently leading the Global Fragility Fracture nurse education team within the FFN. She has co‐authored a number of journal articles, book chapters and books on fragility fracture management and allied subjects.

Professor Rebecca Jester, PhD, BSc (Hons)

Head of the School of Nursing, Royal College of Surgeons in Ireland, Medical University, Bahrain

Rebecca is Head of the School of Nursing, RCSI, Medical University, Bahrain. She qualified as a registered nurse in the UK in 1985. Rebecca then worked as a staff nurse, sister and ward manager in several trauma and orthopaedic settings in the UK and Sweden before completing a BSc (Hons) Education Studies in Nursing in 1995 and embarking on a clinical academic career working across the interface of education, research and clinical practice. Rebecca was awarded a PhD in Health Sciences from the University of Birmingham in 2001, supported by a National Smith and Nephew Fellowship. She was awarded a personal chair (professorship) in Orthopaedic Nursing in 2008 by Keele University and has held several senior academic positions, including Head of the School of Nursing and Midwifery, Keele University, Head of the Nursing School Abu Dhabi for Griffith University and Head of Department of Adult Nursing and Midwifery, London South Bank University. She holds several honorary positions internationally, including Emeritus Professor of Nursing, University of Wolverhampton, UK, Honorary Advisor to The Hong Kong College of Orthopaedic Nursing, Associate Editor of the International Journal of Trauma and Orthopaedic Nursing and Adjunct Professor of Orthopaedic Nursing Research at the University of Southern Denmark. Rebecca has many years of experience as an advanced nurse practitioner in orthopaedics whilst working in her academic roles and she was awarded Fellow of Nursing by the Hong Kong Academy of Nursing (May 2021) for contribution to excellence in nursing and advancement of nursing practice. Rebecca has a track record of research and associated publications in clinical research related to orthopaedic care.

Julia Judd, MSc, RSCN, RGN, ENB 219

University Hospital Southampton, Child Health. Tremona Rd Southampton, SO16 6YD, UK

Julia is an Advanced Nurse Practitioner in Children's Orthopaedics at the University Hospital Southampton, UK. She qualified as an RSCN and RGN at Queen Mary's Hospital for Children in Carshalton and subsequently gained her orthopaedic qualification and her Master's degree. Julia has a passion for promoting expertise and best practice through the organisation of and presenting at children's orthopaedic conferences. Julia has published extensively, both articles and book contributions, and is a reviewer for the International Journal of Orthopaedic Trauma Nursing. She is actively involved with a number of different national and international research projects, specifically focusing on developmental dysplasia of the hip, Perthes disease, clubfoot and the orthopaedic manifestations of vitamin D deficiency. Julia is co‐chair of the RCN Society of Orthopaedic and Trauma Nursing.

Dr Carolyn Mackintosh‐Franklin, RN, BA (Hons), MSc, PhD, PGDIp HE

Reader, University of Manchester, Manchester, UK

Carolyn is a registered nurse with many years' experience in pain management as a pioneering clinical nurse specialist and educationalist. Her most recent work focuses on educating nurses and other healthcare professionals to develop greater understanding of the nature of pain so that assessment and management can be improved for all pain sufferers. This includes the development of both undergraduate and postgraduate education programmes as well as embedding education around pain assessment and management into pre‐registration undergraduate programmes. Carolyn's own area of research focuses on healthcare staff and their attitudes towards people experiencing pain based on existing evidence that demonstrates only slow improvements made in pain management, and the large numbers of people who continue to experience unnecessary and prolonged suffering as a result of poor pain assessment and inadequate management. Healthcare staff, personal attitudes and limited knowledge about pain are likely to be significant factors underpinning this failure to improve care and proactive educational programmes may support future practice improvements, as well as reduce unnecessary suffering.

Rosemary Masterson, RGN, ONC (ENB 219), BNS, MSc in Nursing

National Orthopaedic Hospital, Cappagh, Dublin, Ireland

Rosemary undertook her general training in the north‐west of Ireland before completing the ENB 219 certificate in Orthopaedic Nursing at the Royal National Orthopaedic Hospital in Stanmore, London. She has worked in both orthopaedic elective and trauma settings in Ireland and London. She has undertaken the role of book review editor for the International Journal of Orthopaedic and Trauma Nursing in the past and contributes to international and national orthopaedic nursing conferences. Rosemary currently acts as treasurer of the Irish Orthopaedic Interest Group. She undertook her Bachelor of Nursing Studies degree at University College Dublin and in conjunction with the Royal College of Nursing and the University of Manchester completed a Master's degree in Nursing. She currently works as a nurse tutor and part of this role involves delivering the specialist modules on a Postgraduate Diploma Orthopaedic Programme run in conjunction with the Royal College of Surgeons in Ireland.

Paul McLiesh, RN, BN, GDip Orth, MNSc, PhD candidate

University of Adelaide, Australia

Paul is a senior lecturer; he completed his initial training as a registered nurse at the Royal Adelaide Hospital in 1989 and has worked in a number of roles over the subsequent 23 years. He has been lecturing in the Adelaide Nursing School at the University of Adelaide since 2010 and is an education specialist through the Adelaide Education Academy. He is the Education Officer for the Centre for Evidence‐based Practice South Australia, an affiliated centre of the Joanna Briggs Institute, and was president of the Australian and New Zealand Orthopaedic Nurses Association (2013–2015) and the South Australian Orthopaedic Nurses Association (2014–2016). He is a deputy editor of the International Journal of Orthopaedic and Trauma Nursing and a PhD candidate focusing on the use of structure nursing assessment tools and their value for use by nurses with varying levels of expertise teaching.

Pamela Moore, PgCert Specialist Practitioner in Orthopaedic Nursing, BSc (Hons), RGN

Nursing Development Lead, Belfast Health & Social Care Trust, Belfast, UK

Pamela has many years of experience in both managerial and ‘hands on’ roles within a busy dedicated fracture clinic/unit and as a development lead for orthopaedic and fracture trauma practice. Pamela is passionate about orthopaedic and fracture trauma care and values ongoing nurse education. Pamela is a frequent specialist lecturer on the orthopaedic and fracture trauma programmes and Objective Structured Clinical Examination examiner at Queen's University Belfast.

Mr Martyn Neil, FRCS, DipSEM (GB&I), MSc

Clinical Director – Orthopaedic Surgery, Consultant Trauma and Orthopaedic Surgeon, Belfast Health & Social Care Trust, Belfast, UK

Martyn has worked in the Royal Victoria Hospital and Musgrave Park Hospital Royal from 2013. He has held the appointment of Clinical Director – Orthopaedic Surgery since 2021.

Lynne Newton‐Triggs, MA, RGN, Pre‐Assessment Sister

Bedford Hospital NHS Trust, Bedford, UK

Lynne currently works as a pre‐assessment nurse manager at a district general hospital with her main focus being the orthopaedic specialty. She qualified as an RGN in 1984 and has since worked in both elective and trauma environments as a ward sister and specialist nurse. She completed the English National Board 219 at the Robert Jones and Agnes Hunt Orthopaedic Hospital in 1987 and has since completed a BA (Hons) degree in Nursing Studies and an MA in Healthcare Ethics.

Jean Rogers, RGN, BSc (Hons), MSc, ONC, Cert. Ed (Fe)

Practice Education Facilitator for the Open University

Jean qualified as an RGN in 1988 from Salford NHS Foundation Trust. She has worked in a number of areas, including elective orthopaedics, acute trauma and ENT, rheumatology and endocrinology, acute medicine and acute rehabilitation. She undertook the orthopaedic course at the Robert Jones and Agnes Hunt Orthopaedic Hospital in 1991 where she was in the last group to undertake the 12‐month course and in her spare time completed a Certificate in Higher Education. Following this Jean held the posts of senior staff nurse, junior sister and lecturer/practitioner, and completed a BSc (Hons) in Nursing Practice and an MSc in Professional Development. She is co‐author of the Oxford University Press book Handbook of Orthopaedic and Trauma Nursing as well as numerous articles. Her main interests lie in orthopaedics, nurse education and the politics of nursing, and she takes an active role in these areas, being a member of the orthopaedic forum, the practice educator's special interest group and the RCN Education Forum. Jean's current post is as academic assessor and practice tutor for the Open University, where she believes that she has the best of both worlds educating and supporting the nurses of the future in the practice setting.

Dr Julie Santy‐Tomlinson (Co‐editor of the first edition), PhD, RGN, RNT, MSc, BSc (Hons)

Julie has been Editor of the International Journal of Orthopaedic and Trauma Nursing since 2007. She has a clinical background in orthopaedic and trauma nursing with a focus on trauma care, older people, fragility fracture, tissue viability and wound care. She has published numerous articles and chapters related to many aspects of orthopaedic and trauma nursing. She has worked in nursing education since 1995.

Helen Stradling, MSc, BA (Hons), ENB 931, M01750, ENB 237

Sarcoma Specialist Nurse and Support Line Manager, Sarcoma UK, London, UK

Helen qualified from the University of Birmingham in 1998. From there she took up the post of staff nurse at the Nuffield Orthopaedic Centre in Oxford. It was here she was able to mix her passion for orthopaedics and oncology as the sarcoma patients were nursed on the ward. During the first few years on the ward, Helen began to increase her knowledge relating to sarcoma and undertook study in both oncology and orthopaedics. In 2004, the Nuffield Orthopaedic Centre became one of five national centres for the care of bone and soft sarcoma, and it was at this point that Helen was successful in her application for the role of Macmillan Specialist Nurse for musculoskeletal oncology. During the 12 years in that post, Helen grew the sarcoma nursing service in Oxford and introduced nurse‐led follow‐up for all sarcoma patients. Helen was awarded the Nursing Times Cancer Nurse Leader of the Year award in 2010 in recognition of all the work she had put into improving the pathway for sarcoma patients and their families in Oxford. Helen became the first Chair of the National Sarcoma Forum in September 2011. She also became a Trustee of the charity Sarcoma UK in 2013, and in 2016 she decided to leave the team in Oxford and join the Sarcoma UK staff team as a sarcoma specialist nurse and support line manager. Helen was also able to use her sarcoma knowledge to take forward the charity's strategic plan to continue raising awareness, improving the timeliness of diagnosis and undertaking research to bring about new treatments for all those affected by sarcoma.

Anna Timms, RGN, BSc Psychology, ONC

Limb Reconstruction Clinical Nurse Specialist, Royal National Orthopaedic Hospital, Stanmore

Anna qualified from the Queen Elizabeth School of Nursing, Birmingham in 1994. Since then she has specialised within the fields of rheumatology and orthopaedics. Working within the trauma environment at the Royal London Hospital, she became a limb reconstruction nurse specialist in 2005, leaving to become a member of the team at the Royal National Orthopaedic Hospital in 2012. She has authored articles and presented both nationally and internationally in the field of limb reconstruction.

Elizabeth Wright, RGN, RSCN, MSc Advanced Clinical Practice

Advanced Nurse Practitioner, University Hospital, Southampton, UK

Since qualifying at the Hammersmith Hospital, London, Liz gained experience in general paediatric and neonatal intensive care nursing and then entered the specialist field of orthopaedic paediatric nursing in 1990. She was sister of a paediatric orthopaedic ward for 6 years, then a nurse specialist until she commenced her current post of advanced nurse practitioner, completing her MSc in Advanced Nurse Practice in 2004. She has jointly convened and chaired several national paediatric orthopaedic conferences, established and chaired the Royal College of Nursing (RCN) Children and Young Peoples Orthopaedic and Trauma Group in 1998, participates in the RCN Society of Orthopaedic and Trauma Nursing (SOTN), and has been a member of various SOTN work panels and the SOTN Scientific Committee. She has published and presented several times on the subject of paediatric orthopaedics. More recently, Liz has been a core member of the James Lind Priority Setting Partnership, setting priorities for research, and the British Society Children's Orthopaedic Surgery Consensus Group for Congenital Talipes Equinus Varus.

Elaine Wylie, RGN BSc (Hons) PGDip, Specialist Practice Registration: Rheumatology

Nurse Specialist, Southern Health and Social Care Trust, Northern Ireland, UK

Elaine has worked in rheumatology for 31 years and for the last 21 years has been a nurse specialist. She was appointed to the role of Rheumatology Biologics Manager/Lead Nurse Specialist in 2019. She is currently based at Craigavon Area Hospital, where her clinical responsibilities include nurse‐led biologic therapy clinics, review clinics, telephone review clinics and helpline services. She also manages the biologics service and a team of nurse specialists. She is involved in service development locally and regionally, and has mentored rheumatology nurses in Italy to extend their role and service. Her specific interests in rheumatology are inflammatory arthritis patient and family education and support, along with staff training and development. Elaine teaches on the orthopaedic specialist course at Queen's University Belfast and has presented at meetings locally, nationally and internationally.

Sian Rodger, Spinal Cord Injury Educator (clinical), MSc, BSc (Hons), RN (adult), Royal National Orthopaedic Hospital NHS Trust

Sian is a patient education and health coaching clinical nurse specialist at the London Spinal Cord Injury Centre. A product of project 2000 (1996) Sian has gone on to achieve her BSc Hons in professional nursing practice (spinal cord injury) and a Masters in Clinical Research (2020). Sian has had peer reviewed article s published in Nursing Times and British Journal of Nursing and writes a regular on‐line blog for the Nursing Times. She also organises the nurses’ online journal club at the RNOH. Sian has worked within the field of spinal cord injury nursing for most of her nursing career‐ 25 years! She continues to work clinically with patients and staff to educate them in spinal cord injury.

Foreword

Welcome to the second edition of Orthopaedic and Trauma Nursing: An Evidence‐Based Approach to Musculoskeletal Care. Since the publication of the first edition the world has faced one of its most serious challenges to health with the COVID‐19 pandemic, which has impacted on so many of us individually and as healthcare professionals. Orthopaedic and trauma care has been significantly impacted, with many elective procedures being cancelled, patient consultations being delivered remotely using telemedicine and staff being deployed outside of the speciality. It is important to take a moment to reflect and remember family, friends and colleagues who have been affected by COVID‐19.

The first edition of this book received a tremendous amount of positive feedback from students, practitioners and educators globally regarding how it influenced patient care and contributed to practitioners' knowledge and competence. I am delighted to say that the second edition builds on this solid platform, providing essential updates and including contributions from a wide range of practitioners, educators and researchers with many years of expertise in orthopaedic and trauma care from many parts of the globe. I have had the privilege to work with many of the contributors through my role as Deputy Editor of the International Journal of Orthopaedic and Trauma Nursing and being a member of the guideline development group for the Royal College of Nursing Society of Trauma and Orthopaedic Nursing competency document, and can attest to their expertise and passion for orthopaedic and trauma care.

Every chapter has been reviewed and updated to include the latest evidence‐based practice, policy and guidelines. Changes to practice since the first edition include the global implementation of enhanced recovery pathways aiming to shorten hospital length of stay and ensure safe and effective discharge and rehabilitation. Enhanced recovery pathways are based on interdisciplinary teams working in partnership with patients and their families, and embrace shared decision making between practitioners and patients. Rehabilitation has also become embedded in many enhanced recovery pathways to optimise patients' health status prior to elective surgery. Increasingly, patients are spending less time in the inpatient setting with more shared models of care with primary and community services.

Technology continues to provide opportunities to work in new ways, including patient consultations for follow‐up assessment being carried out remotely using tele‐medicine, which has enabled patients to continue to receive expert care when face‐to‐face consultations were not possible due to COVID‐19. This has required practitioners to develop new skills in assessment and consultation when not having the patient in the same room and has also required patients to engage with practitioners in a different way. Technology is also supporting patients with rapid and easier access to information and monitoring. Many orthopaedic and trauma teams have developed apps that patients can access to gain information about their condition, treatment and care, and can also be used to support patients with their rehabilitation and exercise regimens.

Specialist and advanced practice roles continue to develop within the speciality globally, making a significant impact on services such as fragility fracture and osteoporosis treatment and care, and there is a growing realisation of the need to increase health promotion and prevention in orthopaedic conditions and to address the issue of rising rates of obesity and its detrimental impact on the musculoskeletal system.

My vision for this text is that it will find its way onto wards and departments where staff and students can dip into it to check best practice, and ultimately that it influences the quality of patient care and safety. I also hope that the book becomes a core text on the reading lists of specialist orthopaedic programmes globally and a useful resource for undergraduate nursing and therapy students. I am fortunate to have networks in orthopaedics in the UK, Hong Kong, Denmark and the Middle East, and can attest to this book having relevance and value to practice and education globally. I will certainly be using the book on a regular basis and if you are looking for an orthopaedic and trauma text to support evidence‐based contemporary practice this is a must‐read.

Rebecca Jester

Head of the School of Nursing, Royal College of Surgeons in Ireland, Medical University

Deputy Editor, International Journal of Orthopaedic and Trauma Nursing

Preface

Welcome to the second edition of this book. Orthopaedic and trauma care remains a highly specialised aspect of healthcare focused on the person with musculoskeletal problems or injury and following orthopaedic surgery. Such care is delivered across the lifespan, i.e. birth to death, in a wide range of community and hospital settings. The skills required for effective, evidence‐based practice must be developed through a regard for the knowledge and evidence base for practice coupled with development of competence and expertise. This area of healthcare shares generic skills but encompasses specialist skills like no other. The aim of this 25‐chapter edition is to provide practitioners working in orthopaedic and musculoskeletal trauma settings with the evidence, guidance and knowledge required to develop their skills and underpin effective practice.

This book continues to reflect the focus on the practice of musculoskeletal care as well as putting a specific focus on the evidence base for that practice. It builds on the first edition and differs with a larger focus on fragility fractures across two chapters, 18 and 19. All other chapters have been updated and modified by either their original author(s) or new co‐authors from clinical practice and/or higher education. For example, we are delighted to welcome Mrs Julie Craig (Chapters 17 and 20) and Mr Martyn Neil (Chapter 20) from the Trauma and Orthopaedic Department, Royal Victoria Hospital, Belfast, as well as paramedic Dr Stefanie Cormack (Chapter 16) and Paul McLiesh, an Education Officer for the Centre for Evidence‐based Practice in South Australia, who has revamped Chapter 2