Address correspondence to Elaine Burland, Department of Community Health Sciences, University of Manitoba, Manitoba Centre for Health Policy (MCHP), 408-727 McDermot Ave., Winnipeg, Manitoba R3E 3P5, Canada. E-mail:
Gerontologist. 2013 Oct;53(5):828-38. doi: 10.1093/geront/gns197. Epub 2013 Jan 25.
This study evaluates a nursing home Fall Management program to see if residents' mobility increased and injurious falls decreased.
Administrative health care use and fall occurrence report data were analyzed from 2 rural health regions in Manitoba, Canada, from June 1, 2003 to March 31, 2008. A quasiexperimental, pre-post, comparison group design was used to compare rates of three outcomes, falls, injurious falls, and falls resulting in hospitalization, by RHA (program vs nonprogram nursing homes) and period (preprogram vs postprogram). Data collectors entered occurrence report information into spreadsheets. This was supplemented with administrative health care use data.
The program appears to have benefitted residents-falls trended upward, injurious falls remained stable, and hospitalized falls decreased significantly (0.036-0.021 per person-year [ppy]; p = .043). Compared with nonprogram residents in the postperiod, both groups had the same fall rate, but program residents had significantly fewer injurious falls (0.596-0.746 ppy; p = .02) and hospitalized falls (0.02-0.041 ppy; p = .023).
These results are among a small body of literature showing that Fall Management was associated with improved outcomes in program nursing homes from pre- to postperiod and compared with nonprogram nursing homes. This research provides some support for the benefits of being proactive and implementing injury prevention strategies universally and pre-emptively before a resident falls, helping to minimize injuries while keeping residents mobile and active. Larger scale research is needed to identify the true effectiveness of the Fall Management program and generalizability of results.
本研究评估了一家养老院的跌倒管理计划,以观察居民的活动能力是否提高以及伤害性跌倒是否减少。
利用加拿大马尼托巴省 2 个农村卫生区域的行政医疗保健使用和跌倒事件报告数据,于 2003 年 6 月 1 日至 2008 年 3 月 31 日进行分析。采用准实验、前后对照、比较组设计,按 RHA(计划内和计划外养老院)和时期(计划前和计划后)比较三种结局的发生率,即跌倒、伤害性跌倒和导致住院的跌倒。数据收集员将事件报告信息输入电子表格。这一数据通过行政医疗保健使用数据得到补充。
该计划似乎使居民受益——跌倒发生率呈上升趋势,伤害性跌倒保持稳定,而住院跌倒显著下降(0.036-0.021 人年[ppy];p=0.043)。与后时期计划外的居民相比,两组的跌倒发生率相同,但计划内的居民伤害性跌倒和住院跌倒显著减少(0.596-0.746 ppy;p=0.02)和住院跌倒(0.02-0.041 ppy;p=0.023)。
这些结果是为数不多的表明跌倒管理与计划内养老院在计划前至计划后期间以及与计划外养老院相比结果改善相关的文献之一。本研究为积极主动地实施普遍的预防伤害策略提供了一些支持,这些策略在居民跌倒前预先采取行动,有助于最大限度地减少伤害,同时保持居民的活动能力和活跃性。需要更大规模的研究来确定跌倒管理计划的真正有效性和结果的普遍性。