Skip to main content
SpringerLink
Log in

Role of method of implementing multi-factorial falls prevention in nursing homes for elderly persons. The EUNESE project

  • Original Articles
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims: 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).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Geriatrics Society, British Geriatrics Society and American Academy of Orthopedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664–72.

    Article  Google Scholar 

  2. Izumi K, Makimoto K, Kato M, Hiramatsu T. Prospective study of fall risk assessment among institutionalized elderly in Japan. Nurs Health Sci 2002; 4: 141–7.

    Article  PubMed  Google Scholar 

  3. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–7.

    Article  CAS  PubMed  Google Scholar 

  4. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35-S2: ii37-ii41.

  5. Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res 2003; 15: 43–50.

    Article  PubMed  Google Scholar 

  6. Becker C, Loy S, Sander S, Nicolaus T, Rissmann U, Kron M. An algorithm to screen long-term care residents at risk for accidental falls. Aging Clin Exp Res 2005; 17: 186–92.

    Article  PubMed  Google Scholar 

  7. Petridou ETh, Kyllekidis S, Jeffrey S, Chishti P, Dessypris N, Stone DH. Unintentional injury mortality in the European Union: how many more lives could be saved? Scand J Public Health 2007; 35: 278–87.

    Article  PubMed  Google Scholar 

  8. Injury statistics. Mortality data. WHO data edited by CEREPRI. Available at http://www.euroipn.org/stats_portal/modules.php?name=mortalityDev.26-7-2006. Accessed 26.07.2006.

  9. Cumming RG, Salkeld G, Thomas M et al. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000; 55: M299–305.

    Article  CAS  PubMed  Google Scholar 

  10. Gillespie SM, Friedman SM. Fear of falling in new long-term care enrollees. J Am Med Dir Assoc 2007; 8: 307–13.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Rubenstein LZ, Powers CM, MacLean CH. Quality indicators for the management and prevention of falls and mobility problems in vulnerable elders. Ann Intern Med 2001; 135: 686–93.

    Article  CAS  PubMed  Google Scholar 

  12. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall?JAMA 2007; 297: 77–86.

    Article  PubMed  Google Scholar 

  13. Chang JT, Morton SC, Rubenstein LZ et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ 2004; 328: 676–82.

    Article  Google Scholar 

  14. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews 2003, Issue 4. Art. No.: CD000340. DOI: 10.1002/14651858.CD000340.

  15. Jensen J, Lundin-Olsson L, Nyberg L, Gustafson Y. Fall and injury prevention in older people living in residential care facilities. Ann Intern Med 2002; 136: 733–41.

    Article  PubMed  Google Scholar 

  16. Becker C, Kron M, Lindemann U et al. Effectiveness of a multifaceted intervention on falls in nursing home residents. J Am Geriatr Soc 2003; 51: 306–13.

    Article  PubMed  Google Scholar 

  17. Dyer CAE, Taylor GJ, Reed M, Dyer CA. Falls prevention in residential care homes: a randomized controlled trial. Age Ageing 2004; 33: 596–602.

    Article  PubMed  Google Scholar 

  18. McMurdo ME, Millar AM, Daly F. A randomized controlled trial of fall prevention strategies in old peoples’ homes. Gerontology 2000; 46: 83–7.

    Article  CAS  PubMed  Google Scholar 

  19. Vu MQ, Weintraub N, Rubenstein LZ. Falls in the nursing home: are they preventable? J Am Med Dir Assoc 2006; 7 (3 Suppl): S53–8, 52.

    Article  PubMed  Google Scholar 

  20. Oliver D, Connelly JB, Victor CR et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ 2007; 334: 82–8.

    Article  PubMed  Google Scholar 

  21. Crotty M, Whitehead C, Rowett D et al. An outreach intervention to implement evidence based practice in residential care: a randomized controlled trial [ISRCTN67855475]. BMC Health Serv Res 2004; 4: 6. [http://www.biomedcentral.com/1472-6963/4/6]

    Article  PubMed Central  PubMed  Google Scholar 

  22. Rubenstein LZ, Robbins AS, Josephson KR, Schulman BL, Oserweil D. The value of assessing falls in an elderly population. A randomized clinical trial. Ann Intern Med 1990; 113: 308–16.

    CAS  Google Scholar 

  23. Coló-Emeric C, Schenck A, Gorospe J et al. Translating evidence-based falls prevention into clinical practice in nursing facilities: results and lessons from a quality improvement collaborative. J Am Geriatr Soc 2006; 54: 1414–18.

    Article  Google Scholar 

  24. Clinical practice guidelines for assessment and prevention of falls in older people. National Institute of Clinical Excellence (NICE), London, Nov. 2004.

  25. Tinetti M. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119–26.

    CAS  PubMed  Google Scholar 

  26. Abrams WB, Beers MH, Berkow R. The Merck Manual of Geriatrics 2nd ed. Whitehouse Station, N.J.: Merck Research Laboratories; 1995: Excerpt 232–4.

    Google Scholar 

  27. Thapa PB, Gideon P, Brockman KG, Fought RL, Ray WA. Clinical and biomechanical measures of balance as fall predictors in ambulatory nursing home residents. J Gerontol A Biol Sci Med Sci 1996; 51A: M239–46.

    Article  Google Scholar 

  28. Rockwood K, Await E, Carver D, Macknight C. Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian Study of Health and Aging. J Gerontol A Biol Sci Med Sci 2000; 5: M70–3.

    Google Scholar 

  29. Rosendahl E, Gustafson Y, Nordin E, Lundin-Olsson L, Nyberg L. A randomized controlled trial of fall prevention by high-intensity functional exercise program for older people living in residential care facilities. Aging Clin Exp Res 2008; 20: 67–75.

    Article  PubMed  Google Scholar 

  30. Hendriks MRC, Bleijlevens MHC, van Haastregt JCM et al. Lack of effectiveness of a multidisciplinary fall-prevention program in elderly people at risk: a randomized, controlled trial. J Am Geriatr Soc 2008; 56: 1390–97.

    Article  PubMed  Google Scholar 

  31. Jensen J, Nyberg L, Rosendahl E, Gustafson Y, Lundin-Olsson L. Effects of a fall prevention program including exercise on mobility and falls in frail older people living in residential care facilities. Aging Clin Exp Res 2004; 16: 283–92.

    Article  PubMed  Google Scholar 

  32. Nowalk MP, Prendergast JM, Bayles CM, D’Amico FJ, Colvin GC. A randomized trial of exercise programs among older individuals living in two long-term care facilities: the Falls FREE program. J Am Geriatr Soc, 2001; 49: 859–65.

    Article  CAS  PubMed  Google Scholar 

  33. Oddsson LIE, Boissy P, Melzer I. How to improve gait and balance function in elderly individuals — compliance with principles of training. Eur Rev Aging Phys Act 2007; 4: 15–23.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Public Health, Jagiellonian University Medical College, Ul Grzegórzecka 20, 31-531, Kraków, Poland

    Katarzyna Szczerbińska MD, PhD

  2. Chair of Clinical Rehabilitation, University School of Physical Education, Krakow, Poland

    Marek Żak

  3. Institute of Anthropology, Polish Academy of Sciences, Wroclaw, Poland

    Anna Ziomkiewicz

Authors
  1. Katarzyna Szczerbińska MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marek Żak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Ziomkiewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katarzyna Szczerbińska MD, PhD.

Additional information

The present paper is presented in the context of the EUNESE project (Grant Agreement 2003316) implemented within the framework of EC Public Health Programme (2003–2008) under the auspices of DG-SANCO, and partly supported by the Polish Ministry of Science and Higher Education, grant no. 164/Zdrowie Publiczne/2007/7.

A poster announcing the findings of this study was presented during the 2nd EuroSafe Conference, 9–10 October 2008 in Paris, but has not yet been published, apart from the abstract in the conference book.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Szczerbińska, K., Żak, M. & Ziomkiewicz, A. Role of method of implementing multi-factorial falls prevention in nursing homes for elderly persons. The EUNESE project. Aging Clin Exp Res 22, 261–269 (2010). https://doi.org/10.1007/BF03324806

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03324806

Keywords

Search

Navigation