Clinicians’ experiences of discontinuing routine hip precautions following total hip replacement surgery: a qualitative analysis

Lightfoot, Courtney J.; Coole, Carol; Sehat, Kos; Brewin, Catherine; Drummond, Avril

Abstract

Purpose: Hip precautions are routinely provided in the UK, despite evidence suggesting that they are no longer needed. A change in practice was introduced into an orthopaedic service whereby the provision of routine hip precautions was discontinued for selected individuals receiving a primary total hip replacement. The change involved implementing a new regime of “no precautions” which was facilitated using a number of key strategies. The aim of this study was to explore the experiences of clinicians associated with the change in practice. Material and methods: Individual semi-structured interviews were conducted with clinicians who had experience of delivering both hip precautions and no hip precaution regimes. Data were analysed thematically. Results: Ten orthopaedic staff (two senior occupational therapists, one occupational therapy support worker, three senior physiotherapists, two surgeons, and two senior nurses) were interviewed. Three main themes were identified: changes experienced, perceptions of the new regime, and challenges experienced. Conclusion: Several barriers and facilitators to the successful changeover were identified. Successful strategies in changing practice included assigning “Hip Champions”, staff education and targeted training. It is proposed that holding multidisciplinary education and training would be the ideal model.Implications for rehabilitation Key strategies for changing practice were educating staff and providing targeted training. Multidisciplinary training might prevent discrepancies in the advice given to patients. Appointing “Hip Champions” provided clear role models and enabled new clinical behaviours to be enforced.

Citation

Lightfoot, C. J., Coole, C., Sehat, K., Brewin, C., & Drummond, A. (2022). Clinicians’ experiences of discontinuing routine hip precautions following total hip replacement surgery: a qualitative analysis. Disability and Rehabilitation, 44(16), 4227-4232. https://doi.org/10.1080/09638288.2021.1884759

• Journal Article Type: Article
• Acceptance Date: Jan 29, 2021
• Online Publication Date: Feb 15, 2021
• Publication Date: 2022
• Deposit Date: Feb 2, 2021
• Publicly Available Date: Feb 16, 2022
• Journal: Disability and Rehabilitation
• Print ISSN: 0963-8288
• Electronic ISSN: 1464-5165
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 44
• Issue: 16
• Pages: 4227-4232
• DOI: https://doi.org/10.1080/09638288.2021.1884759
• Keywords: Rehabilitation
• Public URL: https://nottingham-repository.worktribe.com/output/5289131
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/09638288.2021.1884759
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 15/02/2021, available online: https://www.tandfonline.com/doi/abs/10.1080/09638288.2021.1884759?journalCode=idre20