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Evaluation of a protocol for hip-protectors in a subacute geriatric institution
Dr. Ch. De Clercq, Dr. J.-C. Lemper
Introduction:
With this retrospective case study we evaluated whether our selection-protocol for initiating a test-period with ?HIPS? (hip protectors) in a geriatric population correlated with the percentage of patients who finally purchased the HIPS.
Methods:
We used a questionnaire evaluating risk-factors for repetitive falling. If ? 4/6 risk-factors were answered positively, we initiated a HIPS testing-period. If < 4/6 risk-factors were answered positively, we conducted a Tinetti-test where a test score of ? 19 also led to a HIPS testing-period. The HIPS testing-period consisted of costless use of the system for a period of 2 weeks, after which a purchase was proposed.
Results:
We included 83 (83%) of 100 consecutively admitted patients (61 females, 39 males, mean age 82,7 years). Seventeen (17%) patients were not enrolled because of missed inclusion or being bedridden. Sixty-six of 83 (79%) patients had less than 4 risk-factors (group 1), 17/83 (21%) were immediately included in the testing period (? 4 risk factors, group 2). In 57/83 (69%) patients of group 1 a Tinetti-test was conducted; 9/83 (11%) patients were excluded from the test (palliative setting, dementia, prior use of HIPS). Tinetti-scores of ? 19 were obtained in 27/83 patients (33%) who were added to the patients from group 2 (total N = 44/83, 53%). Twelve of 83 patients (15%) didn?t complete the HIPS-testing period (clinical deterioration, wounds, dismissal, ?) so that eventually 32/83 (39%) patients completed the testing period. After 2 weeks 7/83 (8,5%) patients purchased the HIPS.
Conclusion:
Despite the implementation of a strict selection-protocol, the purchase of HIPS seems too expensive and too uncomfortable for patients with a high risk of hip fractures. To promote the use of HIPS in daily practice, we recommend the institution to provide the system at no cost.
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