title: Role of method of implementing multi-factorial falls prevention in nursing homes for elderly persons. The EUNESE project.
abstract: 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).
authors.affiliation: Institute of Public Health, Jagiellonian University Medical College, Ul Grzegórzecka 20, 31-531 Kraków, Poland. mxszczer@cyf-kr.edu.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szczerbinska
authors.forename: Marek
authors.initials: M
authors.lastname: Zak
authors.forename: Anna
authors.initials: A
authors.lastname: Ziomkiewicz
mesh_terms: 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