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Int J Nurs Stud. 2018 Jun;82:139-148. doi: 10.1016/j.ijnurstu.2018.03.014. Epub 2018 Mar 17.

Determinants of staff commitment to hip protectors in long-term care: A cross-sectional survey.

Author information

1
Injury Prevention and Mobility Laboratory (IPML), Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada; Centre for Hip Health and Mobility, 7/F, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: akorall@sfu.ca.
2
Department of Statistics and Actuarial Science, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. Electronic address: tloughin@sfu.ca.
3
Injury Prevention and Mobility Laboratory (IPML), Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada; Patient Safety and Injury Prevention, Fraser Health Authority, Suite 400, 13450 102nd Avenue, Surrey, BC, V3T 5X3, Canada. Electronic address: Fabio.Feldman@fraserhealth.ca.
4
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, St. Leonards, NSW 2065, Australia. Electronic address: ian.cameron@sydney.edu.au.
5
Patient Safety and Injury Prevention, Fraser Health Authority, Suite 400, 13450 102nd Avenue, Surrey, BC, V3T 5X3, Canada; New Vista Care Home, 7550 Rosewood Street, Burnaby, BC, V5E 3Z3, Canada. Electronic address: Ming.Leung@fraserhealth.ca.
6
Centre for Hip Health and Mobility, 7/F, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Department of Family Practice, University of British Columbia, 3/F, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada. Electronic address: simsg@mail.ubc.ca.
7
Geriatric Medicine Research, Nova Scotia Health Authority, 5955 Veteran's Memorial Lane, Halifax, NS, B3H 2E1, Canada. Electronic address: Judith.Godin@nshealth.ca.
8
Injury Prevention and Mobility Laboratory (IPML), Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada; Centre for Hip Health and Mobility, 7/F, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. Electronic address: stever@sfu.ca.

Abstract

BACKGROUND:

If worn, certain models of hip protectors are highly effective at preventing hip fractures from falls in residents of long-term care, but modest acceptance and adherence have limited the effectiveness of hip protectors. Residents of long-term care are more likely to accept the initial offer of hip protectors and to adhere to recommendations concerning the use of hip protectors when staff are committed to supporting the application of hip protectors. Yet, we know very little about the nature of and factors associated with staff commitment to hip protectors in long-term care.

OBJECTIVE:

To identify factors associated with staff commitment to hip protectors in long-term care.

DESIGN:

A cross-sectional survey.

SETTING:

Thirteen long-term care homes (total beds = 1816) from a single regional health district in British Columbia, Canada.

PARTICIPANTS:

A convenience sample of 535 paid staff who worked most of their time (>50% of work hours) at a participating long-term care home, for at least one month, and for at least 8 h per week. We excluded six (1.1%) respondents who were unaware of hip protectors. Of the remaining 529 respondents, 90% were female and 55% were health care assistants.

METHODS:

Respondents completed the Commitment to Hip Protectors Index to indicate their commitment to hip protectors. We used Bayesian Model Averaging logistic regression to model staff commitment as a function of personal variables, experiences with hip protectors, intraorganizational communication and influence, and organizational context.

RESULTS:

Staff commitment was negatively related to organizational tenure >20 years (posterior probability = 97%; logistic regression coefficient = -0.28; 95% confidence interval = -0.48, -0.08), and awareness of a padded hip fracture (100%; -0.57; -0.69, -0.44). Staff commitment was positively related to the existence of a champion of hip protectors within the home (100%; 0.24; 0.17, 0.31), perceived quality of intraorganizational communication (100%; 0.04; 0.02, 0.05), extent of mutual respect between residents and staff and perceived contribution to quality of life of the residents they serve (100%; 0.10; 0.05, 0.15), and frequency of transformational leadership practices by respondents' primary supervisors (100%; 0.01; 0.01, 0.02).

CONCLUSIONS:

We provide novel insight into the factors governing staff commitment to hip protectors in long-term care. Targeting of these factors could improve acceptance and adherence with hip protectors, thereby contributing to enhanced effectiveness of hip protectors to prevent hip fractures in long-term care.

KEYWORDS:

Accidental falls; Attitude of health personnel; Bayes theorem; Commitment; Cross-sectional survey; Hip fractures; Hip protectors; Nursing homes; Patient compliance

PMID:
29655133
DOI:
10.1016/j.ijnurstu.2018.03.014
[Indexed for MEDLINE]

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