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Monday, November 2, 2009: 2:40 PM
Learning Objective 1: Identify key aspects of the environment to assess when nursing home residents fall.
Learning Objective 2: Describe how environmental risk factors can be modified to prevent future falls.
Background: Falls are a leading cause of injury among adults aged 65 and older, with an estimated 750,000 nursing home residents falling annually. Nursing home environmental factors, while previously suggested as possible contributors to fall events, are not well documented. The purpose of this pilot project is to examine and record environmental factors that may contribute to fall events experienced by elderly nursing home residents. Methods: Currently 11 of the 15 targeted environmental assessments have been performed at a 200-bed non-profit sub-acute and long-term care facility in Baltimore. Environmental assessments include qualitative and quantitative observations of room dimensions, lighting, floor surfaces, furniture and associated factors (i.e. obstacles, call bells). Resident rooms and hallways are assessed by a trained research assistant within 72 hours of consented resident fall events. Descriptive data and qualitative environmental observations were recorded by hand at the time of assessment. Descriptive statistics are computed in Microsoft Excel, and content analysis of the environmental observations was performed in Microsoft Word. Results: Preliminary analyses reveal that furniture and other objects on the floor frequently obstruct access to closets (90%) and bedside drawers (70%). Lighting is observed to be inaccessible (90%), inadequate (30%) or resulting in glare on the floor in 20% of the rooms. Content analyses suggest issues with limited walking space in resident rooms and hallways as well as obstacles/clutter on floor surfaces. Conclusions: Our initial findings highlight the importance of addressing modifiable environmental characteristics when designing interventions to prevent falls experienced by nursing home elders. Overcrowding and clutter in resident rooms, for example, present a hazard for older adults when ambulating and can be easily identified and remedied by nursing staff efforts and the commitment of nursing administration to fall prevention. Funding was provided by the Center for Collaborative Intervention Research: National Institute of Nursing Research P30NRO8995.