Falls in somatic and dementia wards at Community Care Units.
BACKGROUND
Falls and fall injuries are common problems for patients at nursing homes in Sweden. Impaired cognitive function, a poor sense of orientation and a high intake of medicine, can lead to an increase in falls among older people.


OBJECTIVE
The objective of this study was to investigate the associations between falls and: fall risks, fractures, the use of physical restraints and the use of certain medications in somatic and dementia wards, respectively.


METHODS
The study design is ecological, and aggregated data regarding falls, fall risk assessments, fractures, the use of physical restraints and medication were collected between 2000 and 2003. The Pearson correlation analysis and regression analyses were used to investigate associations between fall risks, medication, fractures, wheelchair-bound situations, bed rails and falls.


RESULTS
The total number of reported fall incidents was 2651; of these, 737 incidents were registered in dementia wards and 1914 in somatic wards. Dementia wards and somatic wards differed regarding falls and fractures, as it was only in dementia wards that falls were associated with fractures. There was also a significant correlation between falls and assessed risk of falling, the use of certain medication, and physical restraints such as wheelchairs and bed rails in dementia wards. Falls at somatic wards were associated with the use of sleeping pills with benzodiazepines.


CONCLUSIONS
For dementia wards there were associations between falls and fractures, physical restraints and the use of certain medications. Fractures were associated with the use of neuroleptics, sleeping pills and sleeping pills with benzodiazepines. At somatic wards, falls correlated with the use of sleeping pills with benzodiazepines, and with the use of wheelchairs and bed rails.
Fonad
Edit
E
Stockholms Sjukhem Foundation, Stockholm, Sweden. edit.fonad@telia.com
Emami
Azita
A
Wahlin
Tarja-Brita Robins
TB
Winblad
Bengt
B
Sandmark
Helene
H
D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D003704:Dementia; D064420:Drug-Related Side Effects and Adverse Reactions; D036262:Empirical Research; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D009735:Nursing Homes; D012149:Restraint, Physical; D018570:Risk Assessment / Q000706:statistics & numerical data; D020886:Somatosensory Disorders; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology