Hip fractures are a significant health risk for seniors. Hip fractures in long-term care residents may be reduced by preventing and treating osteoporosis, preventing falls, and by using hip protectors. Hip protectors are garments or undergarments with pockets for protective pads that protect the hips in the case of a fall.
The Canadian Agency for Drugs and Technologies in Health (CADTH) conducted a pilot project to provide policy guidance and an implementation tool on hip protectors in long-term care facilities. The policy guidance and implementation tool are based primarily on an evidence synthesis conducted by CADTH and on input by a panel of Canadian experts.
CADTH’s work on this project resulted in the following key messages:
- Hip protectors should be considered as one element of effective institutional, regional, or provincial/territorial injury prevention strategies for seniors in long-term care facilities.
- Hip protectors benefit some long-term care residents more than others. Specific criteria should be applied to determine which seniors would benefit most (e.g., residents with previous falls or fractures, osteoporosis, cognitive impairment; women over 70; and where hip protectors will not greatly interfere with activities of daily living).
- Long-term care staff and clinicians need to work closely with long-term care residents and their families to determine which type of hip protector best suits the needs of the resident. The preference of the resident must be considered.
- To allow for consistent use by residents in long-term care facilities, an adequate number of hip protectors need to be provided.
The Canadian Agency for Drugs and Technologies in Health (CADTH) developed the following tools to help transition the policy guidance developed from the hip protectors project into practice:
- Hip Protectors: A Summary — created in partnership with the Canadian Standards Association (CSA) and overviews the labelling and testing of hip protectors (July 2017).
- Buying and Care Instructions for a Hip Protector: What You Need to Know — created in partnership with the Canadian Standards Association (CSA) as a guidance card for consumers looking to buy and maintain a hip protector (July 2017).
- Guidance Card
- Policy Guidance
The guidance card implementation tool is mainly intended for staff at long-term care facilities but may be of interest to health professionals in general, as well as those working within a health ministry, health region, or hospital.
To make these tools relevant to different audiences, CADTH can tailor specific tools to individual needs and settings. Contact us if you would like our assistance in tailoring any of these tools to meet your unique needs as a health care provider, policy-maker, or consumer.
Partnership With Fraser Health
In its role as a broker of health technology information, CADTH partnered with Fabio Feldman at Fraser Health to help disseminate the results of a systematic review he and his colleagues had conducted on hip protector compliance, acceptance, and adherence. Dr. Feldman was part of the expert panel that helped produce CADTH recommendations on hip protectors.
As part of this partnership, CADTH hosted a webinar entitled “Hip Protectors: How to Make Them Work in Your Facility,” which delivered evidence on hip protectors, including CADTH’s work on this topic, to hundreds of administrators and health professionals of long-term care facilities across Canada. The webinar presented research on the biomechanical effectiveness of hip protectors and strategies to increase their use. An archived version of the webinar and related information can be accessed using the links on the right-hand side of this page.
This listing is not intended to be all-inclusive or to imply endorsement by CADTH.
- Safer Healthcare Now! Falls Intervention
- Finding Balance Alberta
- Institute for Healthcare Improvement Reducing Harm from Falls
- Registered Nurses’ Association of Ontario: Prevention of Falls and Fall Injuries in the Older Adult
- Mississauga Halton Falls Prevention Project
- BC Injury Research and Prevention Unit Falls Prevention
- Centre of Excellence on Mobility, Fall Prevention and Injury in Aging (CEMFIA), British Columbia
- Cochrane: Interventions for Preventing Falls in Older People in Nursing Care Facilities and Hospitals
- Neurology: Practice Parameter: Assessing Patients in a Neurology Practice for Risk of Falls (an evidence-based review)
- The Journals of Gerontology (Medical Sciences): Predictors of Adherence with the Recommended Use of Hip Protectors
Our project on hip protectors resulted in the following reports:
- Hip Protectors in Long-Term Care: A Clinical and Cost-Effectiveness Review and Primary Economic Evaluation, CADTH Rapid Review, 2008
- Hip Protectors in Long-Term Care: Clinical and Cost-Effectiveness, CADTH Rapid Review (Update), 2010