Skip to main content
SpringerLink
Log in

A follow-up study on fall and fracture incidence in long-term care including the role of formal caregiver time on fall incidence rates

Eine Follow-up-Studie zur Sturz- und Frakturinzidenz bei Pflegeheimbewohnern unter besonderer Beachtung des Einflusses der verfügbaren Arbeitszeit von Pflegemitarbeitern

  • CONTRIBUTION TO THE MAIN TOPIC
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Summary

Objective

To examine the impact of a fall prevention programme over a 12 month follow-up period after the introduction of a RCT and to describe possible differences between incidence density rate of falls associated with caregiver time during weekends and ordinary working days.

Design

Prospective observational study, duration 12 months.

Setting

Six community nursing homes, Germany.

Participants

Long-stay residents (n=881); 771 resident years; median age 85.0 years (min 60; max 101); 79.1% female.

Measurements

Incidence density rate of falls and fractures, staff time per resident.

Results

The incidence density rate over all days was 1367/1000 resident years (RY) for falls [95% confidence interval 1041;1693]. The incidence density rate of hip fractures was 29/1000 RY [95% confidence interval 12;45] and 29/1000 RY [95% confidence interval 12;45] for non-hip fractures. The incidence density rate showed similar results comparing weekends/ public holidays vs normal working days; falls 1193 vs 1447/ 1000 RY; hip fractures 25 vs 30/ 1000 RY and other fractures 16 vs 34/1000 RY.

Conclusion

During the period, we observed a marked decline of the fracture rate compared with the controlled phase of the intervention trial. A lower number of nursing care hours on weekends was not associated with a higher incidence density rate for falls, fallers, or any type of fracture.

Zusammenfassung

Ziel der Untersuchung

Untersuchung des Effekts eines Sturzpräventionsprogramms im Pflegeheimbereich in den 12 Verlaufsmonaten nach Abschluss der kontrollierten Phase unter Beteiligung der Warteeinrichtungen. Beschreibung der Inzidenzdichteraten der Ereignisse unter Beachtung der Pflegezeit im Vergleich von Werktagen und Wochenenden.

Studiendesign

Prospektive zwölfmonatige Beobachtungsstudie.

Setting

Sechs Pflegeeinrichtungen einer Stadt in Süddeutschland.

Teilnehmer

881 Heimbewohner (771 Bewohnerjahre), Altersmedian 85,0 (Min. 60, Max. 101) davon 79,1% Frauen.

Messungen

Inzidenzdichteraten der Stürze und Frakturen, verfügbare Arbeitszeit der Pflegemitarbeiter.

Ergebnisse

Die Inzidenzdichterate lag bei 1367/1000 Bewohnerjahre (BJ) für Stürze [95% Konfidenzintervall (KI) 1041;1693]. Die Inzidenzdichterate der PFF lag bei 29/1000 BJ [95% KI 12;45] and 29/1000 BJ [95% KI 12;45] für andere Frakturen. Die Inzidenzdichteraten zeigten vergleichbare Zahlen an Wochentagen und Wochenenden sowohl bei Stürzen 1193 vs. 1447/ 1000 BJ; Hüftfrakturen 25 vs. 30/ 1000 BJ und bei anderen Frakturen 16 vs. 34/1000 RY.

Zusammenfassung

Im Beobachtungszeitraum kam es zu einem deutlichen Rückgang der Frakturraten gegenüber dem Zeitraum der kontrollierten Phase der Interventionsstudie. Eine niedrige Arbeitszeit am Wochenende und an Feiertagen war nicht mit einer erhöhten Sturz- und Frakturhäufigkeit verbunden

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

Literatur

  1. Aiken L, Clarke S, Douglas M, Sloane D, Sochalski J, Silber J (2002) Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J Am Med Ass 288:1987–1993

    Article  Google Scholar 

  2. Arbesman MC, Wright C (1999) Mechanical restraints, rehabilitation therapies, and staffing adequacy as risk factors for falls in an elderly hospitalized population. Rehabilitation Nursing 24:122–128

    PubMed  CAS  Google Scholar 

  3. Becker C, Kron M, Lindemann U, Sturm, Eichner B, Walter-Jung B, Nikolaus Th (2003) Effectiveness of a multifaceted intervention on falls in nursing home residents. J Am Geriat Soc 51:306–313

    Article  PubMed  Google Scholar 

  4. Blake C, Morfitt JM (1986) Falls and staffing in a residential home for elderly people. Public Health 100:385–391

    Article  PubMed  CAS  Google Scholar 

  5. Cali CM, Kiel DP (1995) An epidemiologic study of fall-related fractures among institutionalized older people. J Am Geriatr Soc 43:1336–1340

    PubMed  CAS  Google Scholar 

  6. Dolinis J, Harrison JE, Andrews GR (1997) Factors associated with falling in older Adelaide residents. Aust New Zealand J Publ Health 21:462–468

    CAS  Google Scholar 

  7. Donner A, Klar N (2000) Design and analysis of cluster randomization trials in health care. Arnold, London 106:132–133

    Google Scholar 

  8. Gillespie LD, Gillespie WJ, Cumming R, Lamb SE, Rowe BH (2001) Interventions for preventing falls in the elderly. Cochrane Database of Systematic Reviews

  9. Harrington C, Zimmermann, Karon SL, Robinson J, Beutel P (2000) Nursing home staffing and its relationship to deficiencies. J Gerontol B Psych Sci Soc Sci 55:278–287

    Google Scholar 

  10. Jensen J, Lundin-Olsson L, Nyberg L, Gustavson Y (2002) Fall and injury prevention in older people living in residential care facilities. A cluster randomized trial. Ann Intern Med 136:733–741

    PubMed  Google Scholar 

  11. Jørstad EC, Hauer K, Becker C, Nakash R, Skelton DA, Lamb SA, on behalf of the ProFaNE Group (2005 b) Physical activity questionnaires in fall prevention intervention trials: a systematic review. J Aging Phys Activ, pp 461–481

  12. Kiely DK, Kiel DP, Burrows AB, Lipsitz LA (1998) Identifying nursing home residents at risk for falling. J Am Geriat Soc 46:551–556

    PubMed  CAS  Google Scholar 

  13. Kovner C (2001) The impact of staffing and the organization of work on patient outcomes and health care workers in health care organizations. Jt Comm J Qual Improv 27:458–468

    PubMed  CAS  Google Scholar 

  14. Kron M, Loy S, Nikolaus Th, Becker C (2003) Risk factors for falls in institutionalised frail elderly. Am J Epidem, pp 645–653

  15. Lamb SE, Jørstad EC, Hauer K, Becker C (2005) Development of a common outcome data set for fall injury prevention trials. J Am Geriat Soc, pp 1688–1622

  16. Luukinen H, Koski K, Laippal P, Kivela SL (1995) Risk factors for recurrent falls in the elderly in long-term institutional care. Public Health 109:57–65

    Article  PubMed  CAS  Google Scholar 

  17. Meyer G, Warnke A, Bender R, Mühlhauser I (2003) Effect on hip fractures in nursing homes: cluster randomised controlled trial. Br Med J 326:1–5

    Google Scholar 

  18. Myers AH, Baker SP, van Natta ML, Abbey H, Robinson EG (1991) Risk factors associated with falls and injuries among elderly institutionalized persons. Am J Epid 133:1179–1190

    CAS  Google Scholar 

  19. Needleham J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K (2002) Nurse-staffing levels and the quality of care in hospitals. N Engl J Med 346:1715–1722

    Article  Google Scholar 

  20. Rubenstein LZ, Josephson KR, Osterweil D (1996) Falls and fall prevention in the nursing home. Clin Geriat Med 12:881–902

    CAS  Google Scholar 

  21. Thapa PB, Brockman KG, Gideon P, Fought RL, Ray WA (1996) Injurious falls in nonambulatory nursing home residents: A comparative study of circumstances, incidence, and risk factors. J Am Geriat Soc 44:273–278

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Robert-Bosch-Krankenhaus, Klinik für Geriatrische Rehabilitation, Auerbachstr. 110, 70397, Stuttgart, Germany

    Clemens Becker MD, U. Rißmann, K. Rapp & B Lindemann

  2. University of Ulm, Department of Biometry and Clinical Documentation, Schwabstr. 13, 89075, Ulm, Germany

    S. Loy & M. Kron

  3. Bethesda Geriatrische Klinik Ulm, Zollernring 26, 89073, Ulm, Germany

    Th. Nikolaus

Authors
  1. Clemens Becker MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Loy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Th. Nikolaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. U. Rißmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Rapp
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B Lindemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Kron
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Becker, C., Loy, S., Nikolaus, T. et al. A follow-up study on fall and fracture incidence in long-term care including the role of formal caregiver time on fall incidence rates. Z Gerontol Geriatr 39, 292–296 (2006). https://doi.org/10.1007/s00391-006-0399-x

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-006-0399-x

Key words

Schlüsselwörter

Search

Navigation