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

ObjectivesTo investigate adherence to the urinary function assessments of the national falls guidelines for England and Wales.Study designSecondary data analysis of the 2006 National Clinical Audit of Falls and Bone Health.SettingAcute hospitals in the UK.ParticipantsPatients aged 65 years and older with a fragility fracture as a result of a fall.Main outcome measuresData 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.Results63% (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).ConclusionRates of assessment and action for those with who fall and have continence problems are low despite current national guidelines.