Falls in the nursing home setting: does time matter?

OBJECTIVES

Falls increase morbidity and mortality among nursing home residents and have varied causes and risk factors. The purpose of this study was to assess whether falls in nursing home residents were more prevalent at particular times of the day.

DESIGN/PARTICIPANTS: This study was a retrospective chart review for falls in a skilled nursing facility in New York from January to June, 2007.

RESULTS

There were 220 falls during the 6-month period. Most falls (66%) occurred in the resident's room and almost half (48%) resulted in an injury. Falls during the evening were likely to result in a more serious injury than daytime falls (P = .03). A statistically significant higher percentage of falls (27%) occurred between 4 pm and 8 pm (compared with expected number in a 4-hour period, P < .001). Among the 3 nursing shifts, the lowest percentage of falls occurred during the 11 pm to 7 am night shift (16%).

CONCLUSION

This study reveals a variation in the prevalence of falls in the nursing home based on time of day that is different from the pattern of falls in the hospital setting. More research is needed to evaluate possible causes of this temporal pattern of falls in the nursing home. Perhaps these data can be used to implement specific interventions at times when falls are more common to reduce the risk of falls.