Adherence to hip protectors and implications for U.S. long-term care settings

Area of Science:

• Gerontology
• Healthcare Management
• Patient Safety

Background:

• Hip fractures are a significant concern in nursing home residents.
• Hip protectors (HP) are a proven intervention to reduce fracture risk.
• Adherence to HP use is crucial for their effectiveness but can be challenging to maintain.

Purpose of the Study:

• To identify nursing home characteristics associated with adherence to hip protector (HP) use.
• To describe adherence patterns and resident characteristics influencing HP use.

Main Methods:

• A multicenter randomized controlled trial involving 35 nursing homes.
• Adherence to HP use was monitored by research staff over 21 months.
• Data collected via interviews, chart reviews, and facility assessments.

Main Results:

• Non-chain-affiliated facilities, those with less Medicaid case-mix, and more paraprofessional staff training demonstrated higher HP adherence.
• Facilities with fewer residents wearing HPs and more rotating staff also showed increased adherence.
• Administrator involvement in meetings was inversely related to adherence.

Conclusions:

• Targeting interventions to facilities with higher Medicaid case-mix can reduce care disparities.
• Enhancing staff training and support is vital for improving HP adherence.
• Personalized HP use strategies may be necessary for residents who cannot maintain consistent adherence.