Role of method of implementing multi-factorial falls prevention in nursing homes for elderly persons. The EUNESE project.
OBJECTIVE
This study was conducted within the European Network for Safety among the Elderly (funded by the EC in European Public Health Programme 2003-2008). The main aim was to assess the effectiveness of two types of implementation of multi-factorial intervention to reduce the incidence of falls in three nursing homes (NHs): one based on the involvement of the entire nursing staff in assessing the risk of falls (in NH A and B) and the other with one well-qualified professional (physiotherapist) to conduct assessment (in NH C).


METHODS
The intervention included: registration of falls throughout the study period (18 months), training of staff in months 5-6, supervised implementation of falls prevention in months 7-12, and a follow-up in the last 6 months. The median values of falls incidence adjusted to 100 mobile residents per month were compared between NHs A, B and C in the three consecutive phases of the observation: pre-intervention, implementation and follow-up, by means of the non-parametrical ANOVA Kruskal-Wallis test.


RESULTS
A statistically significant drop in falls incidence medians was observed during the phases in NH A (5.05 vs 2.52 vs 0.50 respectively; H=8.84, p<0.05) and NH B (4.58 vs 0.38 vs 1.90 respectively; H=8.52, p<0.05). The change was not significant in NH C (3.26 vs 5.43 vs 1.08 respectively; H=3.94, ns).


CONCLUSIONS
Broad NH staff involvement in performing risk of falls assessment is more efficient in reducing the frequency of falls than hiring a single professional (specialized in falls prevention).
Szczerbinska
Katarzyna
K
Institute of Public Health, Jagiellonian University Medical College, Ul Grzegórzecka 20, 31-531 Kraków, Poland. mxszczer@cyf-kr.edu.pl
Zak
Marek
M
Ziomkiewicz
Anna
A
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D017598:Efficiency, Organizational; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D005851:Geriatric Nursing / Q000458:organization & administration / Q000706:statistics & numerical data; D005853:Geriatrics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006284:Health Plan Implementation; D006801:Humans; D015994:Incidence; D007318:Inservice Training / Q000458:organization & administration / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes / Q000458:organization & administration* / Q000706:statistics & numerical data; D026761:Physical Therapy Specialty / Q000458:organization & administration / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D011634:Public Health / Q000706:statistics & numerical data; D012307:Risk Factors; D017751:Safety Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D000078329:Workforce