Fall Prevention in Long-Term Care: An In-House Interdisciplinary Team Approach

Older adults in long-term care are at great risk of injury from falling. An interdisciplinary fall prevention team recommended four classes of interventions for 25 long-term care residents with significant fall histories. Data were collected covering 90-day, pre- and post-intervention time frames. Resident falls evidenced a 39.8% decline (p = .0001). Resident injuries declined 49% consisting of mild (p = .05) and severe injuries (p = .04). The findings of this study suggest that an interdisciplinary fall team is an effective tool for reducing resident falls and fall-related injuries in a long-term care setting.

[1]  B Widder.  A new device to decrease falls. , 1985, Geriatric nursing.

[2]  W A Ray,et al.  A randomized trial of a consultation service to reduce falls in nursing homes. , 1997, JAMA.

[3]  Cameron Swift,et al.  Prevention of falls in the elderly trial (PROFET): a randomised controlled trial , 1999, The Lancet.

[4]  Christianna S. Williams,et al.  Health care utilization and costs in a Medicare population by fall status. , 1998, Medical care.

[5]  R G Marks,et al.  Nocturia: A Risk Factor for Falls in the Elderly , 1992, Journal of the American Geriatrics Society.

[6]  R. Cumming,et al.  Home Visits by an Occupational Therapist for Assessment and Modification of Environmental Hazards: A Randomized Trial of Falls Prevention , 1999, Journal of the American Geriatrics Society.

[7]  L. Rubenstein,et al.  Falls in the Nursing Home , 1994, Annals of Internal Medicine.

[8]  M. Mulvihill,et al.  Alarm Devices Instead of Restraints? , 1992, Journal of the American Geriatrics Society.

[9]  D Osterweil,et al.  The value of assessing falls in an elderly population. A randomized clinical trial. , 1990, Annals of internal medicine.

[10]  A. Campbell,et al.  Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women , 1997, BMJ.

[11]  S. Baker,et al.  Medications and Diagnoses in Relation to Falls in a Long‐Term Care Facility , 1987, Journal of the American Geriatrics Society.

[12]  P. Tariot,et al.  Minimum Data Set Plus (MDS+) Scores Compared with Scores from Five Rating Scales , 1996, Journal of the American Geriatrics Society.

[13]  B. Ytterstad.  The Harstad injury prevention study: the characteristics and distribution of fractures amongst elders--an eight year study. , 1999, International journal of circumpolar health.

[14]  D. Kiel,et al.  Identifying Nursing Home Residents at Risk for Falling , 1998, Journal of the American Geriatrics Society.

[15]  W. L. Ooi,et al.  Nursing rehabilitation and exercise strategies in the nursing home. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[16]  C. Mulrow,et al.  A randomized trial of physical rehabilitation for very frail nursing home residents. , 1994, JAMA.

[17]  R. Craven,et al.  Teach the elderly to prevent falls. , 1986, Journal of gerontological nursing.

[18]  C. Mustard,et al.  Case-control study of exposure to medication and the risk of injurious falls requiring hospitalization among nursing home residents. , 1997, American journal of epidemiology.

[19]  W. Ray,et al.  Injurious Falls in Nonambulatory Nursing Home Residents: A Comparative Study of Circumstances, Incidence, and Risk Factors , 1996, Journal of the American Geriatrics Society.

[20]  A multidisciplinary falls consultation service in a nursing home. , 1991, The Gerontologist.

[21]  D Osterweil,et al.  Falls and fall prevention in the nursing home. , 1996, Clinics in geriatric medicine.

[22]  J. Gurwitz,et al.  The Epidemiology of Adverse and Unexpected Events in the Long‐Term Care Setting , 1994, Journal of the American Geriatrics Society.

[23]  W. Ray,et al.  Psychotropic drugs and risk of recurrent falls in ambulatory nursing home residents. , 1995, American journal of epidemiology.

[24]  D. Kiel,et al.  An Epidemiologic Study of Fall‐Related Fractures Among Institutionalized Older People , 1995, Journal of the American Geriatrics Society.

[25]  J. Mahoney,et al.  Immobility and falls. , 1998, Clinics in geriatric medicine.

[26]  D. Infeld,et al.  Nurse staffing and quality of care in nursing facilities. , 1996, Journal of gerontological nursing.

[27]  H. Nygaard.  Falls and Psychotropic Drug Consumption in Long-Term Care Residents: Is There an Obvious Association? , 1997, Gerontology.

[28]  R Tideiksaar,et al.  Falls prevention: the efficacy of a bed alarm system in an acute-care setting. , 1993, The Mount Sinai journal of medicine, New York.

[29]  D. Galindo-Ciocon,et al.  Initiation and evaluation of a research-based fall prevention program. , 1998, Journal of nursing care quality.

[30]  An interdisciplinary falls consult team: a collaborative approach to patient falls. , 1992 .

[31]  N. P. Erber,et al.  Conversation as therapy for older adults in residential care: the case for intervention. , 1994, European journal of disorders of communication : the journal of the College of Speech and Language Therapists, London.

[32]  G. Rowles,et al.  Individualizing care: family roles in nursing home decision-making. , 1996, Journal of gerontological nursing.

[33]  M. Tinetti.  Factors Associated with Serious Injury During Falls by Ambulatory Nursing Home Residents , 1987, Journal of the American Geriatrics Society.

[34]  J. Orange,et al.  Enhancing Communication in Dementia of the Alzheimer's Type , 1998 .

[35]  D M Buchner,et al.  Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. , 1999, Age and ageing.

[36]  R. Casten,et al.  Psychometric Characteristics of the Minimum Data Set II: Validity , 1998, Journal of the American Geriatrics Society.

[37]  I W Webster,et al.  Clinical parameters associated with falls in an elderly population. , 1993, Gerontology.

[38]  P Laippala,et al.  Risk factors for recurrent falls in the elderly in long-term institutional care. , 1995, Public health.

[39]  L. Teri,et al.  Validity and Responsiveness of the Minimum Data Set , 1999, Journal of the American Geriatrics Society.

[40]  K A Talerico,et al.  Individualized interventions to prevent bed-related falls and reduce siderail use. , 1999, Journal of gerontological nursing.

[41]  B. R. Connell.  Role of the environment in falls prevention. , 1996, Clinics in geriatric medicine.

[42]  I Pyykkö,et al.  Prognosis of falls among elderly nursing home residents , 1995, Aging.

[43]  M. V. Van Natta,et al.  Risk factors associated with falls and injuries among elderly institutionalized persons. , 1991, American journal of epidemiology.

[44]  M. Tinetti,et al.  Prevention of falls among the elderly. , 1989, The New England journal of medicine.

[45]  G. Frisoni,et al.  Fear of falling in nursing home patients. , 1994, Gerontology.

[46]  S. Whitney,et al.  Falls and Balance Issues in Long-Term Care , 1999 .

[47]  R. Cumming,et al.  The cost effectiveness of a home hazard reduction program to reduce falls among older persons , 2000, Australian and New Zealand journal of public health.

[48]  J. Mossey.  Social and psychologic factors related to falls among the elderly. , 1985, Clinics in geriatric medicine.