Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

OBJECTIVE To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. STUDY DESIGN A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. SETTING One hundred-bed not-for-profit long-term care facility. PARTICIPANTS Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). INTERVENTION The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. RESULTS By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. CONCLUSIONS High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.