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Effect on hip fractures of increased use of hip protectors in nursing homes: Cluster randomized controlled trial.

Schoen, Delores C.

Research Update: Hip Fractures

Delores C. Schoen, PhD, RN, C, FAAN, Adjunct Professor, The Pennsylvania State University School of Nursing, University Park, PA.

Hip fractures are common, costly, and clinically serious. The following recent research articles give important information regarding hip fractures from several perspectives.

Effect on hip fractures of increased use of hip protectors in nursing homes: Cluster randomized controlled trial.

Meyer, G., Warnke, A., Bender, R., & Muhlhauser, I., (2003). British Medical Journal, 326(7380), 76–78.

The objective of the study was to assess the effects of an intervention program designed to increase the use of the hip protectors in elderly people in nursing homes. The investigators used a cluster-randomized controlled trial with 18 months of follow-up in a nursing home setting, with 167 residents in the intervention group and 207 in the control group. The intervention consisted of structured education of staff, who, in turn, taught the nursing home residents about the use of hip protectors. Three free hip protectors were given to each resident in the intervention group.

Nursing-home staff attended an educational session that lasted 60 to 90 minutes. Information covered included: (1) information about the risk of hip fracture and related morbidity; (2) strategies to prevent falls and fractures; (3) effectiveness of hip protectors; (4) relevant aspects that interfere with the use of hip protectors, such as aesthetics, comfort, fit, and handling; and (5) strategies for successful implementation. Once the educational session was over, each nurse was then responsible for delivering the same educational program to the residents in their intervention group.

The results of the study showed there were 21 hip fractures (4.6%) in the intervention group and 42 hip fractures in 39 residents (8.1%) in the control group. There were 39 other fractures in the intervention group and 38 in the control group. The use of structured education programs and the provision of free hip protectors in nursing homes increased the use of protectors and reduced the number of hip fractures.

Important to nursing and other healthcare providers is the need to implement interventions that educate elderly individuals about ways they can help themselves to prevent a hip fracture. Providing the hip protectors free of charge was also a major reason for the adoption of the program by the elderly.

© 2003 National Association of Orthopaedic Nurses