A Community Hospital Implementation of a Mobile Preoperative Peripheral Nerve Block Service in Non-OR Environments for Hip Fracture Patients

Background and objective

Peripheral nerve blocks (PNB) are recognized as best practice for managing pain in older adults with fragility hip fractures. Despite strong evidence, the adoption of PNB pre-operation has been slow due to several implementation barriers. This study addresses this gap by describing the co-design and implementation of a preoperative Mobile PNB Service led by anesthesiology in a Canadian community hospital. We aim to: (1) provide a transferable, anesthesia focused implementation roadmap; (2) identify key implementation activities that enable the delivery of PNBs outside the operating room; and (3) report formative feasibility and evaluation outcomes (blocks delivered, pain levels, adverse events, and opioids administered before and after block delivery.