Adverse Events Associated With the Res-Care Intervention

Abstract

The purpose of this secondary data analysis was to evaluate the adverse events associated with a restorative care intervention (Res-Care) in nursing home (NH) residents. A randomized controlled repeated-measure design and generalized estimating equations were used to evaluate status at baseline and 4 and 12 months after initiation of the Res-Care Intervention. Twelve NHs in Maryland. A total of 487 residents; 256 in treatment sites and 231 in control sites, all long-stay NH residents ages 65 and older, with an MMSE of 11 or greater. The Res-Care Intervention was a 2-tiered self-efficacy-based intervention focused on motivating nursing assistants to actively engage residents in functional and physical activities. Baseline (2-month pre-intervention), 4-month, and 12-month records of adverse events, including falls, fall-related injuries, fractures, emergency room (ER) visits, hospital admissions, and death abstracted from NH records. There were significant baseline differences between treatment groups in resident race (more African Americans in control sites) and ER visits (more visits in treatment sites 2 months before intervention). Longitudinal models revealed significant differences in ER visits at 4 months and number of fallers at 12 months that were in the direction of a protective effect of treatment over time. The Res-Care Intervention, which maximizes physical functioning, is safe to conduct in NH residents and does not result in increased risks of falling, injury, or other adverse events.