Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Martha Biddle

Clinical Mentor

Billie May

Committee Member

Debbie Kitchen

Committee Member

Dr. Patricia Howard

Abstract

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in to how to increase vitamin D levels with consideration for supplementation to reduce the incidence of falls/fractures in this population.

Methods: This retrospective descriptive study of electronic medical records data from participants meeting the inclusion criteria admitted to the University of Kentucky Chandler Medical Center from August 2010 through August 2015. Chi-square test and Fisher exact tests were used to test for significance of association between variables.

Results: The sample consisted of 2,767 records of subjects aged 65 years and older, who had fallen and sustained a fracture. The mean age of the subjects was 80.99 years (SD 8.56); the majority of the sample was female and Caucasian. Of the 2,767 records reviewed serum vitamin D level were assessed in 208 subjects (7.5%). Of the 208 subjects whose serum vitamin D level were assessed 28% had an optimal serum level of vitamin D, 32% had an insufficient serum level of vitamin D and 40% had a deficient serum level of vitamin D, the mean serum vitamin D level was 24.32 ng/ml (SD 12.79). A vitamin D level of 30 ng/mL or above was considered optimal. There was a statistically significant association between age and vitamin D level, p = 0.004. There was no statistical differences between, gender and vitamin D level, p =0 .1, race and vitamin D level, p = 0.18, nor between fracture type and vitamin D level, p =0 .202.

Conclusion: Vitamin D levels were assessed in 7.5% of the study sample. Of those 7.5% the vitamin D level was most often insufficient.