A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes.
OBJECTIVE
to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes.


METHODS
a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation.


METHODS
127 nursing and residential homes in the greater Belfast area of Northern Ireland.


METHODS
40 homes in the intervention group (representing 1,366 occupied beds) and 87 homes in the control group (representing 2,751 occupied beds).


METHODS
a policy of making hip protectors available free of charge to residents of nursing homes and supporting the implementation process by employing a nurse facilitator to encourage staff in the homes to promote their use, over a 72-week period.


METHODS
the rate of hip fractures in intervention and control homes, and the level of adherence to use of hip protectors.


RESULTS
there were 85 hip fractures in the intervention homes and 163 in the control homes. The mean fracture rate per 100 residents was 6.22 in the intervention homes and 5.92 in the control homes, giving an adjusted rate ratio for the intervention group compared to the control group of 1.05 (95% CI 0.77, 1.43, P = 0.76). Initial acceptance of the hip protectors was 37.2% (508/1,366) with adherence falling to 19.9% (272/1,366) at 72 weeks.


CONCLUSIONS
making hip protectors available to residents of nursing and residential homes did not reduce the rate of hip fracture. This research does not support the introduction of a policy of providing hip protectors to residents of nursing homes.
O'Halloran
Peter D
PD
School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK.
Cran
Gordon W
GW
Beringer
Timothy R O
TR
Kernohan
George
G
O'Neill
Ciaran
C
Orr
Jean
J
Dunlop
Louise
L
Murray
Liam J
LJ
D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D016000:Cluster Analysis; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009660:Northern Ireland; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011482:Protective Devices / Q000600:supply & distribution*; D012112:Residential Facilities