Home' Southern Health News : Southern Health News - April 2015 Contents LEFT Map of the Hunan Province in China.
RIGHT FMC Orthopaedic Nurse Practitioner
Cheryl Kimber and visiting Chinese Senior
Orthopaedic Nurse Lingli Peng.
A break for coffee may save
breaks in the future
BY JACQUIE VAN SANTEN
A simple conversation between two orthopaedic nurses over a cup of coffee has led to an international project which
aims to improve the diagnosis and care of millions of orthopaedic patients in the Hunan province of China.
Flinders Medical Centre (FMC) Orthopaedic Nurse
Practitioner Cheryl Kimber was chatting to
visiting Chinese Senior Orthopaedic Nurse Lingli
Peng about the growing epidemic of hip fractures
amongst China’s ageing population, and a light
bulb went off in her head.
“We do great work at Flinders in identifying those
at risk of having an osteoporotic fracture and
then educating orthopaedic outpatients at the
grassroots level about bone health, and it occurred
to me that perhaps our model of care could be
adapted for use in the Chinese setting. So Lingli
and I started investigating it,” Cheryl explained.
The result is a research collaboration between
Cheryl; Lingli, who is head nurse of the
orthopaedic ward at Xiangya Hospital in China’s
Hunan province; and Donald Bramwell, the Head
of Education for the International Musculoskeletal
Research Institute (IMRI).
The project has grown out of existing relationships
between Flinders Medical Centre, 1st and 2nd
Xiangya hospitals, and Flinders and Central South
“Hip fracture is experiencing a dramatic worldwide
increase, with Orthopaedics International
projecting that by the year 2050, 6.26 million
people across the globe will experience hip fracture
3.2 million of them in China,” Cheryl said.
“That’s an incredibly high rate for one country, and
experts put it down to an ageing population, a more
sedentary lifestyle and China’s growing fondness for
a western diet. In contrast, Australia can expect to
see 60,000 cases of hip fracture by 2051.”
According to Cheryl, patients at FMC’s Orthopaedic
Outpatient Clinic were at an advantage because
they received education and early identification
of their fragility fracture and were started on an
osteoporosis management plan.
“Often, the first sign a patient has osteoporosis is
when they present to the Emergency Department
with a fracture as a result of a fall or trip from a
standing or sitting height, or simply a low trauma
accident,” she said.
“Once these patients have been treated, and
return to the Outpatient Clinic for follow-up, we
are able to put a plan of action in place to prevent
future ‘frailty fractures’ that may eventually evolve
into a major fracture, such as hip fracture.
“This might include educational pamphlets, or
creating a management pathway that may include
the patient’s general practitioner or a referral
to Southern Adelaide Local Health Network’s
Metabolic Bone Clinic.”
While the model of care has proven very successful
in Australia, it isn’t as simple in China’s Hunan
province – where orthopaedic patients are
generally treated as hospital inpatients, rather than
outpatients and most hospitals have no established
pathway for early diagnosis of osteoporosis.
“So we are aiming to modify our model of
care to better suit the Chinese environment,”
She said orthopaedic nurses in the major trauma
hospitals are the best placed health professionals
to identify at-risk patients and provide culturally
appropriate education and health care.
“Phase One of the project has involved surveying
more than 500 orthopaedic nurses across 14
hospitals in the Hunan province about their
knowledge of orthopaedics and their beliefs
around treatment and education.
“The next phases will see the development of
locally-relevant education programs and modules,
and the development of a pathway for fragility
patients in the orthopaedic wards in Hunan
“This will be initiated by the nursing team with
support from their orthopaedic medical teams.”
The research team’s work is already receiving
international recognition, with Cheryl presenting
the project to two major international orthopaedic
conferences in China and Spain in the past six
“This collaborative project shows how a shared
cup of coffee – plus some hard work and
determination – can lead to major practice changes
and improved outcomes for patients at home and
far across the world,” she said.
SOUTHERN HEALTH NEWS / APRIL 2015 / 3
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