Decreasing the incidence of falls in the nursing home in a cost-conscious environment: a pilot study.

Abstract

To evaluate the prevalence of falls and determine the effectiveness of three simple interventions in decreasing the number of falls in a frail nursing home population. Charts and records were reviewed to determine the prevalence of falls. Falls were tracked according to severity and time and place of occurrence. Interventions were made in three areas: (1) Environmental: Room furniture was repositioned. (2) Staffing: One additional staff member was added (by schedule change) at the time when the incidence of falls was highest. (3) Restorative activity program: A program was added at the time when the incidence of falls was high. Falls data were again collected after the intervention. Before intervention, there were 479 falls resulting in 16 fractures; 221 (46%) of the falls occurred during the 3-11 shift and resulted in 63% (n = 10) of the fractures. After intervention, there were a total of 299 falls and 8 fractures. This represents a statistically significant 38% reduction in the total number of falls and a 50% reduction in the total number of fractures during this period. Additionally, falls on the evening and night shifts were significantly reduced from 221 to 115 falls and 91 to 29 falls, respectively. Our interventions may have contributed to a decrease in the overall number of falls and resultant fractures. Our data suggest these simple, practical, and easy to implement methods may positively impact the number of falls in other institutions as well.