Maturitas · 2011
Is urinary continence considered in the assessment of older people after a fall in England and Wales? Cross-sectional clinical audit results.
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Edwards Rhodri, Martin Finbarr C, Grant Rob, Lowe Derek, Potter Jonathan, Husk Janet, Wagg Adrian
Аннотация
OBJECTIVES: To investigate adherence to the urinary function assessments of the national falls guidelines for England and Wales.
STUDY DESIGN: Secondary data analysis of the 2006 National Clinical Audit of Falls and Bone Health.
SETTING: Acute hospitals in the UK.
PARTICIPANTS: Patients aged 65 years and older with a fragility fracture as a result of a fall.
MAIN OUTCOME MEASURES: Data were analysed to determine whether patients with fragility fractures received an assessment of urinary function including continence status; whether impairment was detected and if action was taken to prevent continence related falls.
RESULTS: 63% (2009) of 3184 patients were assessed for urinary continence following a hip fracture and 41% (817) of these identified a problem. 21% (1187) of 5642 patients with nonhip fragility fractures were assessed and a problem was found in 27% (316). Hip fracture patients were more likely (p<0.0001) to receive a continence assessment and have problems detected. Only about half of those with problems had any intervention or a referral to a continence service. Admission to hospital for nonhip fracture patients was a strong predictor of being assessed (p<0.0001).
CONCLUSION: Rates of assessment and action for those with who fall and have continence problems are low despite current national guidelines.
STUDY DESIGN: Secondary data analysis of the 2006 National Clinical Audit of Falls and Bone Health.
SETTING: Acute hospitals in the UK.
PARTICIPANTS: Patients aged 65 years and older with a fragility fracture as a result of a fall.
MAIN OUTCOME MEASURES: Data were analysed to determine whether patients with fragility fractures received an assessment of urinary function including continence status; whether impairment was detected and if action was taken to prevent continence related falls.
RESULTS: 63% (2009) of 3184 patients were assessed for urinary continence following a hip fracture and 41% (817) of these identified a problem. 21% (1187) of 5642 patients with nonhip fragility fractures were assessed and a problem was found in 27% (316). Hip fracture patients were more likely (p<0.0001) to receive a continence assessment and have problems detected. Only about half of those with problems had any intervention or a referral to a continence service. Admission to hospital for nonhip fracture patients was a strong predictor of being assessed (p<0.0001).
CONCLUSION: Rates of assessment and action for those with who fall and have continence problems are low despite current national guidelines.