Availability and use of hip protectors in residents of nursing homes

Klenk, Jochen; Kurrle, Susan; Rißmann, Ulrich; Kleiner, Andrea; Heinrich, Sven; König, HH; Becker, Clemens; Rapp, Kilian

doi:10.1007/s00198-010-1366-3

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…64% of residents with a hip protector used it during the four weeks prior to the examination. Again, there was a large variability in the prevalence of use of hip protectors between nursing homes [15]; [16].…”

Section: Discussionmentioning

confidence: 99%

Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study

et al. 2011

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BackgroundHip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany.MethodsIn a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure.ResultsIn the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG) and control group (CG). During the one-year intervention period femoral fracture rates were 33.6 (IG) and 41.0/1000 person years (CG), respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93) in residents exposed to the fall and fracture prevention program compared to residents from CG.ConclusionsThe state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes.

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Section: Discussionmentioning

confidence: 99%

Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study

et al. 2011

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“…Also, the issue of developing comprehensive strategies to prevent falling of demented elderly may be more difficult. This is also the case in recommending the wearing of hip protectors [34][35][36].…”

Section: Discussionmentioning

confidence: 94%

Falls in Hip Fracture Patients: Relation between Fall Situations and ADL Capability before Injury

Matsui¹,

Harada²,

Takemura³

et al. 2014

Osteopor Phys

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Volume 2 • Issue 1 • 1000108 and gave their written informed consent to the investigation of their fall situations. Basically, study was designed to select consecutive patients during a certain two-year period, but since the fall situations were ambiguous in about a quarter of the patients, those cases were excluded, and 97 cases were included in this study. This number nearly equals 98 persons, which is calculated as an adequate sample size by the free software G*Power 3, when alpha was set at 0.05, power at 80%, and effect size at 0.4. Eighty cases (82.5%) were females and seventeen (17.5%) were males, and the average age of the patients was 82.3 y.o. (ranging from 55 to 98). Forty-five cases (46.4%) were right side fractures, 52 (53.6%) were left, 35 (36.1%) were femoral neck fractures, 61 (62.9%) trochanteric and 1 case (1.0%) was a subtrochanteric fracture. As for their living situation before injury, 65 cases (67.0%) lived at home, and 32 (33.0%) were nursing home residents. As for their walking ability before injury, 53 cases (54.6%) could go out by him (or her) self, 21 cases (21.6%) could walk independently only inside the house, 18 cases (18.6%) needed some aid or assistance for walking even indoors, and 5 cases (5.2%) lived only around their beds. The average Barthel index score, which represents the basic ADL capability was 79.7 points (± 24.2) (ranging from 5 to 100) [32]. The average MMSE score of the patients was 17.4 ponts (± 8.2) (ranging from 0 to 30). AbstractBackground: Most hip fractures are due to falls among frail elderly people. In order to formulate strategies to prevent falls leading to hip fracture, the characteristics of the falls of patients should be clarified in more detail. We investigate the fall situations of hip fracture patients.

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“…This and additional information was used to calculate the incremental costs of the program during the first 18 months of the implementation [ 16 ]. At the same time, a nursing scientist visited 48 randomly selected participating LTCFs for 1 day and collected information from 4000 residents about each resident’s participation in exercise classes and about each resident’s availability and use of hip protectors [ 17 ]. The information referred to the previous 4 weeks and was provided by the nursing home staff for each resident.…”

Section: Methodsmentioning

confidence: 99%

Long-term evaluation of the implementation of a large fall and fracture prevention program in long-term care facilities

et al. 2018

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BackgroundFalls and fractures are extremely frequent in long-term care facilities (LTCFs). Therefore, a fall and fracture prevention program was started in nearly 1000 LTCFs in Bavaria/Germany between 2007 and 2010. The components of the program were exercise classes, the documentation of falls, environmental adaptations, medication reviews, the recommendation to use hip protectors and education of staff. The present study aimed to provide a comprehensive evaluation of the implementation process of the program regarding results of the implementation phase and the follow-up of 3–9 years after start of implementation.MethodsData from numerous sources were used, including data from published studies, statistical data, health insurance claims data and unpublished data from an online questionnaire. To incorporate different aspects, time periods and results, the RE-AIM framework was applied.ResultsThe program was adopted by 942 of the 1150 eligible LTCFs and reached about 62,000 residents. During the implementation phase exercise classes and recommendation about environmental adaptations were offered in nearly all LTCFs. 13.5% of the residents participated in exercise classes. Hip protectors were available for 9.2% of all residents. In the first implementation wave, femoral fracture rate was significantly reduced by 18% in the first year. At follow-up nearly 90% of all LTCFs still offered exercise classes, which were attended by about 11% of residents. However, only 10% of the exercise classes completely fulfilled the requirements of an effective strength and balance training. Individual advice about environmental adaptations was provided in 74.3% of the LTCFs and nearly all LTCFs claimed to offer hip protectors to their residents. A long-term effect of the program on femoral fractures could not be detected.ConclusionsThe program did not affect the femoral fracture rate in the long run. Possible reasons could be a high turn-over of the staff, a reduced fidelity of training components or a shift in daily priorities among the staff.

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Availability and use of hip protectors in residents of nursing homes

Abstract: Predictors of hip protector availability were sex, the degree of care need, migration status, and welfare aid. The lower availability of hip protectors in residents with welfare aid and migration status may be an indicator for health inequality in the German health system.

Cited by 10 publications

References 15 publications

Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study

Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study

Falls in Hip Fracture Patients: Relation between Fall Situations and ADL Capability before Injury

Long-term evaluation of the implementation of a large fall and fracture prevention program in long-term care facilities

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