Falls and fall risk among nursing home residents.
OBJECTIVE
The aim of this study was to identify risk factors for falls in older people living in nursing homes.


BACKGROUND
Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved.


METHODS
The study was carried out over four years (2000-2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom-restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient-bound. The study covered 2,343 reported incidents.


RESULTS
There was a significant correlation between falls and fractures (r = 0.365, p = 0.004), fall risk and use of wheelchairs (r = 0.406, p = 0.001, safety belts (r = 0.403, p = 0.001 and bed rails (r = 0.446, p = 0.000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0.352, p = 0.005). Associations were also found between fall risk and the use of anti-depressants (r = 0.412, p = 0.001).


CONCLUSIONS
In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti-depressants and sleeping pills, especially benzodiazepines.
Fonad
Edit
E
Stockholm's Sjukhem, Foundation Stockholm and Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden. edit.fonad@telia.com
Wahlin
Tarja-Brita Robins
TB
Winblad
Bengt
B
Emami
Azita
A
Sandmark
Helene
H
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D004856:Postural Balance; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology