An in-service evaluation of hip protector use in residential homes.
BACKGROUND
The establishment of a hip protector service has allowed us to study eligibility, acceptability and compliance with use, reasons for non-use, and the effect of dementia, confusion, incontinence and risk of falling.


METHODS
All residents in all residential homes in Poole were assessed at baseline. All eligible residents were offered 1 week's trial of protectors and those who wished to continue were given a set of protectors. Compliance was assessed at 3, 6 and 12 months. Percentages shown for compliance exclude those who died, were transferred, had lost data or in whom follow-up was not yet completed.


RESULTS
Over 18 months, 873 residents from 47 homes were identified (mean age 88 years, female:male 4.5:1). Of these, 745 were considered eligible to wear protectors (86%) and 535 agreed to wear them after 1 week (72%). Compliance over 12 months was 78%. Most wearers wore protectors every day. At 3 months, 83% of demented compared to 73% of not demented residents (P = 0.023), 86% of always confused, 77% of sometimes confused and 72% of never confused (P < 0.009) and 82% of incontinent compared to 73% of continent residents (P = 0.024) were wearing hip protectors. There was a positive linear trend between the risk of falling and compliance (P = 0.048).


CONCLUSIONS
The results suggest that there is a 48% chance of a resident wearing the protectors after 1 year. The higher compliance among those with dementia, confusion, incontinence and at high risk of falling supports the concept that hip protectors are worn by those at greatest risk of fracture.
Thompson
Paul
P
Poole Hospital NHS Trust, Poole, Dorset BH15 2JB, UK. paul.thompson@poole.nhs.uk
Jones
Carol
C
Dawson
Adrian
A
Thomas
Peter
P
Villar
Tracy
T
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities; D005260:Female; D006615:Hip; D006620:Hip Fractures / Q000517:prevention & control; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011482:Protective Devices / Q000706:statistics & numerical data*