Optimizing the Rehabilitation Process of Older Patients After Hip Fracture Through Nurse-Led Promotion of Early Mobility and Physical Activity in the Hospital: A Narrative Review

Abstract

Context: Hip fractures in older adults are associated with high rates of morbidity, mortality, and long-term disability. Early mobilization post-surgery is a critical factor in improving outcomes. Nurses play a pivotal role in implementing and supporting mobility interventions. However, systemic and patient-related barriers often impede optimal rehabilitation. This narrative review aimed to explore the role of nurses in promoting early mobilization and physical activity in elderly patients following hip fracture. Evidence Acquisition: In this narrative review, literature was identified through comprehensive searches of PubMed, CINAHL, Scopus, and Google Scholar using relevant keywords. Sources from 2010 to 2025 were included, with an emphasis on peer-reviewed articles, clinical guidelines, and policy reports. Thematic synthesis was applied to extract key findings. Emergent themes were organized based on relevance to nurse-led rehabilitation strategies. Narrative development incorporated empirical evidence and expert commentary. Results: The narrative synthesis identified four central themes highlighting nurses' roles in hip fracture rehabilitation. (1) As mobility champions, nurses initiate and support early mobilization within 24 - 48 hours post-surgery, reducing complications like deep vein thrombosis and fostering a culture of movement through encouragement and safety protocols. (2) In tailoring care to patient needs, nurses deliver individualized, patient-centered interventions that boost adherence, address psychological barriers like anxiety, and incorporate family involvement for enhanced motivation. (3) When navigating barriers, nurses overcome patient-related issues (e.g., fear of falling, pain, cognitive impairment) and systemic challenges (e.g., staffing shortages) using educational, emotional, and procedural strategies, while advocating for interdisciplinary collaboration. (4) By embracing technological innovations, such as wearable trackers, mobile apps, and telehealth platforms, nurses improve monitoring, care coordination, and adherence. Conclusions: Nurses play an essential role in optimizing hip fracture rehabilitation through early mobilization, personalized care, and innovative solutions. System-level support and standardized protocols are crucial to enhance the effectiveness of nursing interventions. Addressing existing barriers will reduce disability and healthcare costs. Future research should focus on scalable, technology-enhanced, nurse-led rehabilitation models.