More than one-fifth of short-stay nursing home residents fall after they’ve been admitted, but better certified nursing assistant (CNA) staffing has been linked with a lesser risk of falling, according to a study published in the Journal of the American Geriatrics Society.
After looking at 2006 Minimum Data Set (MDS) assessments of all Medicare/Medicaid patients who were newly-admitted to a nursing home, researchers from the University of Southern California and Brown University found that among more than 230,000 patients in nearly 10,000 nursing homes across the country, 21% sustained at least one fall during their first 30 days in the facility.
The nursing homes’ organizational characteristics were also studied to determine potential factors that might contribute to the amount of falls. The researchers found that higher CNA-to-patient staffing ratios correlated with fewer falls—probably because CNA staff assist patients with much of their day-to-day, high-risk activities of toileting, dressing, and walking/moving.
“Though falls are unintentional, they hardly are insignificant: the Centers for Medicare & Medicaid Services reports fall rates as a quality indicator, and falls of nursing home residents have been associated with greater morbidity, mortality and health care costs,” writes the University of Southern California.
Fall rates among long-term nursing home populations are well-documented, notes USC, but this study may be the first of its kind to specifically analyze fall rates among newly-admitted nursing home residents. “Because new admits are in a novel environment and generally are unfamiliar to staff, identification and management of fall risk poses a particular challenge,” the university notes.
“This study highlights the different health care goals of a population striving to get back to the community, who were mostly admitted for rehabilitation after a hospital stay, relative to long-term patients who reside in the nursing home,” said lead USC researcher Natalie Leland. “A fall can delay or permanently prevent the patient from returning to the community, and identifying risk of falling is essential for implementing fall prevention strategies and facilitating successful discharge back to the community.”
Written by Alyssa Gerace