title: Is urinary continence considered in the assessment of older people after a fall in England and Wales? Cross-sectional clinical audit results.
abstract: OBJECTIVE
  To investigate adherence to the urinary function assessments of the national falls guidelines for England and Wales.
  
  
  METHODS
  Secondary data analysis of the 2006 National Clinical Audit of Falls and Bone Health.
  
  
  METHODS
  Acute hospitals in the UK.
  
  
  METHODS
  Patients aged 65 years and older with a fragility fracture as a result of a fall.
  
  
  METHODS
  Data were analysed to determine whether patients with fragility fractures received an assessment of urinary function including continence status; whether impairment was detected and if action was taken to prevent continence related falls.
  
  
  RESULTS
  63% (2009) of 3184 patients were assessed for urinary continence following a hip fracture and 41% (817) of these identified a problem. 21% (1187) of 5642 patients with nonhip fragility fractures were assessed and a problem was found in 27% (316). Hip fracture patients were more likely (p<0.0001) to receive a continence assessment and have problems detected. Only about half of those with problems had any intervention or a referral to a continence service. Admission to hospital for nonhip fracture patients was a strong predictor of being assessed (p<0.0001).
  
  
  CONCLUSIONS
  Rates of assessment and action for those with who fall and have continence problems are low despite current national guidelines.
authors.affiliation: Department of Geriatric Medicine, University College Hospital London, London, United Kingdom. rhodri_edwards@hotmail.com
authors.forename: Rhodri
authors.initials: R
authors.lastname: Edwards
authors.forename: Finbarr C
authors.initials: FC
authors.lastname: Martin
authors.forename: Rob
authors.initials: R
authors.lastname: Grant
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.forename: Jonathan
authors.initials: J
authors.lastname: Potter
authors.forename: Janet
authors.initials: J
authors.lastname: Husk
authors.forename: Adrian
authors.initials: A
authors.lastname: Wagg
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D015577:Geriatric Assessment / Q000379:methods*; D019983:Guideline Adherence; D006615:Hip; D006760:Hospitalization; D006801:Humans; D008297:Male; D008485:Medical Audit; D010043:Outcome and Process Assessment, Health Care; D011787:Quality of Health Care; D012017:Referral and Consultation; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom; D014549:Urinary Incontinence / Q000150:complications / Q000175:diagnosis*