Background: Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury. Methods: Using a modified Delphi approach with a diverse group of experts, we created the Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. This diverse group of 10 experts consisted of nurses, nurse leaders, physical and occupational therapists, safe patient handling committee representatives, and a fall prevention committee leader. The application of the tool was then tested in the hospital environment by two physical therapists. Findings: Consensus was reached for safe patient handling (SPH) equipment recommendations at each level of the Johns Hopkins Mobility Goal Calculator (JH-Mobility Goal Calculator). Expert SPH equipment recommendations were then added to JH-Mobility Goal Calculator levels to create the JH-Safe Patient Handling Mobility Guide. JH-Safe Patient Handling Mobility Guide equipment suggestions were compared with equipment recommendations from physical therapists revealing strong agreement ( n = 125, 88%). Conclusion: The newly created JH-Safe Patient Handling Mobility Guide provides appropriate safe patient-handling equipment recommendations to help accomplish patients’ daily mobility goals. Applications to Practice: The Johns Hopkins Safe Patient Handling Mobility Guide simultaneously facilitates patient mobility and optimizes safety for nursing staff through recommendations for safe patient handling equipment for use with hospitalized patients.

Rotator cuff tears are a leading cause of shoulder pain and disability in adults. Arthroscopic rotator cuff repair (RCR) aims to improve function and reduce pain. The Patient-Reported Outcome Measurement Information System (PROMIS) Pain Interference (PI) assesses the impact of pain on daily life. This study aimed to identify preoperative predictors of PROMIS PI two years after RCR. Patients undergoing arthroscopic RCR from June 2015 to April 2022 were identified from a prospectively enrolled orthopaedic registry. Chart review of the electronic medical record was performed for demographic factors, surgical factors, and patients' Charlson Comorbidity Index (CCI). Patient-reported outcomes (PROs) were collected at baseline and two years postoperatively, including six PROMIS domains, American Shoulder and Elbow Surgeons score (ASES), numeric pain scales (NPS) of the operative shoulder and body, Tegner Activity Subscale (TAS), and Marx Activity Rating Scale of the upper extremity (MARS UE). Statistical analyses were conducted to identify significant predictors of two-year PROMIS PI scores and change in PROMIS PI from baseline. Among 203 patients, 152 (75%) completed two-year PROs after RCR. On multivariable regression, higher preoperative ASES independently predicted better two-year PROMIS PI (Estimate -0.17, 95% CI -0.25 to -0.08, p<.001), whereas a greater CCI (Estimate 1.14, 95% CI 0.07 to 2.20, p=.037) and higher preoperative PROMIS Depression scores (Estimate 0.38, 95% CI 0.22 to 0.54, p<.001) predicted worse two-year PROMIS PI. Greater CCI (Estimate 2.07, 95% CI 0.07 to 2.21, p<.001) also independently predicted less two-year improvement in PROMIS PI. Better preoperative ASES scores independently predicted better two-year PROMIS PI, while worse preoperative PROMIS Depression, and higher CCI predicted worse two-year PROMIS PI after RCR. Preoperative assessment of these measures is a good indicator of postoperative pain and may inform preoperative counseling in patients undergoing arthroscopic RCR. Level IV, Case Series, Prognosis Study.

Background/Objectives: Timing of fixation of stable slipped capital femoral epiphysis (SCFE) is controversial. As pressure mounts to limit inpatient admissions and procedures, our aim was to investigate whether treatment of SCFE in a delayed manner is a safe alternative to immediate fixation. Our hypothesis was that there would be no difference in complications for stable slips treated immediately (24 h) with screw fixation. Methods: A retrospective review was performed at two academic institutions during a 10-year-period yielding 91 SCFEs. Data collected included patient demographics, time to treatment, radiographic measurements (Southwick angle), and complications. Between-group analysis was performed using Welch’s t-test and Fisher’s exact test. Results: 91 stable SCFEs were identified with a median age of 12.3 years (IQR: 11.4–13.3). A total of 62 (68%) slips were treated immediately while 29 (32%) were treated in a semi-elective manner with a median time from diagnosis to surgery of 4 days (range: 2–11 days). There were no instances of >18° increase in Southwick angle in either group or conversion from stable to unstable slips during the semi-elective period. Overall, 12 (13%) patients experienced complications, but no difference in complication rate was observed between groups (15% vs. 10%, p = 0.75). However, the complication profile varied between groups. Of note, two patients (2%, 2/91) experienced AVN, both of which were treated in a semi-elective manner and underwent in situ pinning. Conclusions: There was no difference in complication rate between stable SCFEs treated immediately or semi-electively; however, the complication profile differed by group. No SCFEs in either group had >18° worsening of the Southwick angle between the time of diagnosis and the time of fixation and there were no conversions of stables slips to unstable slips while waiting for semi-elective surgery. These findings suggest that performing semi-elective surgical fixation within 11 days of diagnosing stable, mild SCFEs appears to be a safe alternative to inpatient admission at the time of diagnosis.

Sports-related injuries of the hip and groin have demonstrated increasing prevalence in pediatric and adolescent athletes. Pediatric injuries require specific consideration of unique factors such as skeletal maturity, apophyseal vulnerability, physeal closure status, and growth-related changes in injury pattern. These injuries include a variety of conditions, including apophyseal injuries, hip dislocations, coxa saltans (snapping hip), femoroacetabular impingement syndrome (FAIS), and stress fractures. Injuries such as hip dislocation and high-risk femoral neck stress fracture require urgent diagnosis and management; however, timely diagnosis and appropriate management is necessary for all pediatric hip injuries to prevent delays in return to sport and long-term complications. The literature synthesized in this narrative review includes randomized controlled trials, systematic reviews, prospective and retrospective studies, and consensus statements to provide a summary of each injury. An overview of pediatric sports injuries of the hip, with emphasis on the epidemiology, presentation, diagnosis, management, and complications, is presented.