A review of falls and injuries of nursing home residents presenting to the emergency department.

BACKGROUND

Falls are frequently reported within the HSE. The Irish Longitudinal Study on Ageing (TILDA) found that 40% of over 50 s experience a fall in a two-year period, with 20% requiring hospital attendance. It has been estimated that the cost of injuries related to falls in older people will increase exponentially over the coming years. There is no national database in Ireland with statistics for nursing home (NH) residents presenting with falls to our Emergency Departments (EDs).

AIM

To review the prevalence and risk factors for nursing home patients presenting to the ED with falls.

DESIGN

Retrospective chart review.

METHOD

Retrospective review of all NH presentations to the ED of a university hospital over one year.

RESULTS

There were 519 ED presentations by NH residents over one year. 48.17% (n = 250) presented with a fall. One-third of ED visits presented during conventional working hours. Falls patients were more likely to be admitted when not reviewed by a GP prior to presentation. The average length of stay for falls admissions was 10.77 days (n = 132), versus 9.56 (n = 153) for admissions with no documented fall. There was no statistical difference in the falls risk medications between the groups. Patients presenting with falls were more likely to have bone protection reviewed during their stay (P = 0.011). Patients with falls were also more likely to use mobility aids (P < 0.001).

CONCLUSION

Rapid referral to falls prevention programmes and the use of standardized care pathways for high falls risk patients are essential for future prevention and management.