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

Abstract

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.