Is urinary continence considered in the assessment of older people after a fall in England and Wales? Cross-sectional clinical audit results

Maturitas. 2011 Jun;69(2):179-83. doi: 10.1016/j.maturitas.2011.03.018. Epub 2011 May 6.

Abstract

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.

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Female
  • Fractures, Bone / etiology
  • Geriatric Assessment / methods*
  • Guideline Adherence*
  • Hip
  • Hospitalization
  • Humans
  • Male
  • Medical Audit
  • Outcome and Process Assessment, Health Care
  • Quality of Health Care*
  • Referral and Consultation
  • State Medicine / standards*
  • United Kingdom
  • Urinary Incontinence / complications
  • Urinary Incontinence / diagnosis*