Falls in Newly Admitted Nursing Home Residents: A National Study

Abstract

OBJECTIVES To examine the relationship between nursing home (NH) organizational characteristics and falls in newly admitted NH residents. DESIGN Observational cross-sectional study from January 1, 2006, to December 31, 2006. SETTING NHs in the United States in 2006. PARTICIPANTS Individuals (n = 230,730) admitted to a NH in 2006 without a prior NH stay and with a follow-up Minimum Data Set (MDS) assessment completed 30 days or more after admission. MEASUREMENTS The relationship between experiencing a fall noted on the MDS assessment and NH characteristics (e.g., staffing, profit and chain status, religious affiliation, hospital-based facility status, number of beds, presence of a special care unit, funding) was examined, adjusting for NH resident characteristics. RESULTS Twenty-one percent of this cohort (n = 47,750) had experienced at least one fall in the NH at the time of the MDS assessment, which was completed for newly admitted NH residents who had at least a 30-day stay. NHs with higher certified nursing assistant (CNA) staffing had lower rates of falls (adjusted odds ratio = 0.97, 95% confidence interval = 0.95–0.99). CONCLUSION For newly admitted NH residents, NHs with higher CNA staffing had a lower fall rate. In an effort to maximize fall prevention efforts, further research is needed to understand the relationship between CNA staffing and falls in this NH population.

Práticas Das Equipas Na Prevenção De Queda Nos Idosos Institucionalizados: Construção E Validação De Escala

“…This information is corroborated by the results of another study, which concluded that one out of five elderly people just admitted to institutions fall in the first days of stay. The authors attributed this to the fact that the institution staff was more familiar with older residents 15 and adjusted preventive measures and surveillance to them, to the detriment of new patients.…”

“…Communication, organizational policies and teamwork are crucial to decreasing the prevalence of fall episodes. 15 A longitudinal, quasi-experimental study whose objective was to evaluate the efficacy of a curriculum of fall prevention based on TeamSTEPPS showed that combining team training with improved communication about fall risks was effective in reducing the prevalence of falls. 16 The first item of the last version of the protocol addresses team discussions of fall risks for different residents; the average for answers was Ẋ=3.980±1.052, and identifying risk factors is crucial to implementing preventive measures and preventing accidents.…”

Falls in long-term care institutions for elderly people: protocol validation

“…The incidence is higher than in residents who have been there longer, because the newcomer has to deal with an unknown environment (12)(13) . Also, the physical space and the presence of the institution staff make the place different from home (5) , which hampers risk identification and control (13) . Furthermore, the unknown environment decreases the elderly person's confidence in the execution of activities of daily living (14) .…”

“…Preparation for institutionalization is little discussed in the literature. However, it is known that one in five elderly people just admitted to LTC units fall within the first days of institutionalization (13) . The incidence is higher than in residents who have been there longer, because the newcomer has to deal with an unknown environment (12)(13) .…”

“…However, it is known that one in five elderly people just admitted to LTC units fall within the first days of institutionalization (13) . The incidence is higher than in residents who have been there longer, because the newcomer has to deal with an unknown environment (12)(13) . Also, the physical space and the presence of the institution staff make the place different from home (5) , which hampers risk identification and control (13) .…”