Partnerships@Work: Hip protection goes high-tech

The proclaimed oldest retirement community in Florida has adopted a new product featuring an ultra-modern material in an attempt to prevent one of the most common and debilitating injuries among the elderly: hip fractures.

The 100-year-old Advent Christian Village at Dowling Park (ACV) in Live Oak, Fla., provides a full continuum of care—skilled nursing, assisted living and independent living, as well as a fully equipped medical center—and has a population of about 750 residents. It is a restraint-free facility that encourages mobility and independence among the residents in its nursing units. Although ACV’s falls management committee and the falls management program it oversees seek to decrease the incidence of falls, accidents occur, and one of their consequences can be hip fractures.

| Related article: Beyond fall prevention: Solving the hip fracture crisis |

Keri Hilliard, NHA, vice president of health services for ACV, oversees the operation of the campus’s skilled nursing facility (SNF) and assisted living facility (ALF). Preventing hip fractures, she says, is a top priority. “More than 90 percent of hip fractures are caused by falls and are associated with significant morbidity, mortality and costs,” Hilliard points out.

To help mitigate the risk of fall-related hip fractures for ambulatory residents, ACV had purchased hip protectors years ago as part of its falls management program. Residents and staff members didn’t like the devices, however, and the facility did not experience fewer fractures from falls. In fact, although hip protectors are nothing new in long-term care (LTC) and assisted living settings, many communities, despite investing in the protective devices, do not see a measurable decline in hip fractures after purchasing them. The primary reason for their ineffectiveness? Inconsistent use. Much like the practice of driving while wearing a seatbelt, the protectors must be worn at all times to increase the chances that a resident will be protected when a fall occurs.

INCREASING USE

Friday Harbor, Wash.-based Medical Protection Technologies (MedProTech) began offering Fall-Safe hip protectors in conjunction with UK licensor Hip Impact Protection and D30 Lab in 2012 after studying why SNFs and ALFs were not using existing models even after spending a substantial amount of money on them.

“We looked at the problems of the design of the hip protectors on the market, because they are such an intuitive way to go in terms of preventing fracture,” says D. Stephen Robins, MD, MedProTech’s CEO and medical director. “Our research showed that largest problem wasn’t in efficacy of the products; the issue was one of use—the practical concerns of comfort, convenience and pricing. So we designed a product to come up with solutions to those practical concerns.”

When Hilliard and her colleagues at ACV heard of MedProTech’s Fall-Safe hip protector, they thought it might be the solution to the problem of inconsistent use while providing an increased degree of impact protection thanks to new technology. ACV contacted Robins’ team and received samples of the product.

TESTING THE PRODUCT

At the company’s suggestion, staff members wore the garments as part of an effort to evaluate them before purchase. They found them both comfortable and easy to care for. These benefits, Robins says, can be attributed to the D30 material from which the pads are made. (See sidebar, “Soft armor,” below)

After staff testing, Hilliard concluded that “the pad is much easier to insert into the garment and doesn't get bunched up. It is much more comfortable—very soft and thin, but sturdy.” The device previously used by ACV, Hilliard says, did not have removable pads.

Over four months, the provider also tested the protectors with residents, who embraced the idea of wearing the new devices. ACV subsequently purchased the protectors, and front-line staff members were trained in their use and care.

DESIGN, CARE ARE DRAWS

ACV was drawn in part to the device’s anatomic design—which was curved, not flat like other models—and comfort of the MedProTech product. “Older hip protectors were cumbersome and awkward, especially while sleeping,” Robin says. “Again, the issue of actually wearing a protector consistently is so important, so we knew its use had to be easily absorbed into daily life.”

Ease of care was another issue. Hilliard says that previous undergarment products they tried bunched and twisted in the laundry and didn’t hold up to multiple washes the way they had hoped. Those with removable pads were difficult and time-consuming to care for as well, Hilliard says. The staff at ACV found the Fall-Safe product better able to withstand machine washing and drying and required a less lengthy laundry process.

FEWER FRACTURES, CHAIR ALARMS

ACV has experienced fewer hip fractures in the six months since testing and adopting the device, Hilliard says. In addition, “We also have reduced the use of chair alarms, which was a goal of ours,” she adds. “We have had no problems with residents complaining about or refusing to wear the hip protectors, as we had in the past. Another benefit? The hip protectors allow residents to be more active, which ACV “strongly promote[s],” Hilliard says.

Operators of facilities will have to look beyond the bottom line to see the benefits for hip protection, Robins says. “These are not something you can be reimbursed or bill for, but they offer long-term health and financial benefits related to reducing hip fractures, he says, adding, “There are still 300,000 hip fractures each year despite the fact that hip protectors have been around for 20 years.”

It is his hope, and undoubtedly the hope of older adults and senior living providers across the country, that perhaps an old idea, along with new technology, can help reduce that number.

Soft armor

What is D30? It’s been described as “orange goo” and likened to Silly Putty, but this past December, MSN named D30 one of “10 mind-blowing man-made substances.” A Daily Mail reporter also recently tested the oozy, gelatinous polymer by wrapping some of it around his fingers, then striking them with a hammer—and remaining uninjured.

Although D30, the material in Medical Protection Technologies’ (MedProTech’s) Fall-Safe hip protectors, is new to the healthcare arena, the product has been used in some rather extreme applications for nearly a decade. Created by British company D30 Lab, the patented technology first came onto the scene during the 2006 Winter Olympics to help safeguard skiers from fall-related injuries. Since then, D30 applications have been developed for other sports, consumer products, footwear and the military and law enforcement fields. MedProTech’s Fall-Safe hip protectors are the first medical devices to use the invention.

With what the manufacturer calls “intelligent molecular engineering,” the molecules of D30 are loosely positioned, creating a material that is designed to be soft, pliable and moldable. During an impact, however, such as a fall or the aforementioned hammer strike, the molecules instantly “lock” together, yielding shock absorption in an effort to reduce the force of impact and potential damage to the body underneath. According to the manufacturer, at the instant the impact ends, the molecules return to their loose structure until the material is struck again.

Gina LaVecchia Ragone is a Cleveland-based freelance writer.

See other articles in our Partnerships@Work series here.