JAMDA
Volume 8, Issue 4 , Pages 229-232, May 2007

The Use of Hip Protectors in Long-Term Care Facilities: A Survey of Nursing Home Staff

  • Anna M. Sawka, MD, PhD

      Affiliations

    • Division of Endocrinology and Department of Medicine, University Health Network and University of Toronto, Ontario, Canada
    • Corresponding Author InformationAddress correspondence to Anna M. Sawka, MD, PhD, Toronto General Hospital, 200 Elizabeth Street, Eaton North 12-212, Toronto, Ontario, Canada M5G 2C4.
  • ,
  • Madeline Nixon, MSc

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Lora Giangregorio, PhD

      Affiliations

    • Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
  • ,
  • Lehana Thabane, PhD

      Affiliations

    • Centre for Evaluation of Medicines, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
    • Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada
  • ,
  • Jonathan D. Adachi, MD

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
    • Division of Rheumatology, Department of Medicine, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
  • ,
  • Amiram Gafni, PhD

      Affiliations

    • Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada
    • Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Ron Goeree, MA

      Affiliations

    • Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada
    • Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
    • Program for Assessment of Technology in Health (PATH), St Joseph’s Healthcare, Hamilton, Ontario, Canada
  • ,
  • Parminder Raina, PhD

      Affiliations

    • Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada
  • ,
  • Jennifer Ranford, MA

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Alexandra Papaioannou, MD

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
    • Division of Geriatrics and Department of Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada.

published online 24 April 2007.

Objectives

To determine the level of exposure to hip protectors and barriers to their use in nursing homes.

Design, Setting, and Participants

We conducted a written survey of 160 staff (including administrators) in 5 nursing homes in the Hamilton-Wentworth region, Ontario, Canada.

Measurements

The results of primary analyses were expressed as percentage of respondents.

Results

Among respondents of respective institutions, the rate of prior exposure to hip protectors varied from 40.9% to 100.0% and the rate of prior experience applying these devices varied from 14.3% to 80.0%. The most frequently cited main barriers to the use of hip protectors in long-term care facilities included physicians not thinking to prescribe them, expense, lack of evidence of benefit in this population, wearer discomfort, and wearer removal. A lack of staff time to apply these devices was rarely cited. The majority of staff believed that nursing home residents with a prior history of fracture, those who fall frequently, or those who are unsteady on their feet should wear hip protectors.

Conclusions

The exposure of surveyed nursing home staff to hip protectors was variable but most agreed that residents who are at increased risk of hip fracture should wear them. Some identified barriers to the use of hip protectors in long-term care facilities were physicians not thinking to prescribe them, expense, lack of evidence of benefit in this population, wearer discomfort, and wearer removal. Such barriers need to be addressed for hip protector implementation strategies to be successful in nursing homes.

Keywords: Hip protectors, hip fracture, nursing home

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 This study was funded by an Interdisciplinary Capacity Enhancement (ICE) Team Grant focused on Reducing the Burden of Injury in Canada from The Canadian Institutes of Health Research (CIHR). Co-investigators on the ICE project are P. Raina, C. Macarthur, P. Holowaty, A. Howard, B. Morrongiello, and H. Shannon. Reviewers from the sponsoring agency provided a critique of the study design and methods at the grant application stage but the sponsoring agency had no further direct role in the study. Anna Sawka is a Canadian Institutes of Health Research New Investigator.

 The authors have no conflicts of interest to declare related to the subject of this manuscript.

PII: S1525-8610(06)00625-6

doi:10.1016/j.jamda.2006.12.023

JAMDA
Volume 8, Issue 4 , Pages 229-232, May 2007