[The characteristics of falls based on the prospective registration in nursing home]

Abstract

Knowledge of the most frequent circumstances of falls is crucial from a doctor's, nurse's or caregiver's point of view, as it allows them to anticipate the threat of a fall and to take appropriate precautionary measures. It is for this reason that a fall registration system has been developed within the EUNESE (EUropean NEtwork for Safety among Elderly) international project, and then introduced in 4 nursing homes (NH) for older and chronically ill people and for chronic psychiatric patients. The article presents the results of a year's registration of falls in these facilities, also describing the typical features of the falls, considering the type of NH. The study revealed that the falls occured most frequently in a resident's room, while walking or getting up from a bed, chair, wheelchair or toilet seat, as a result of tripping or slipping on slippery, wet or insufficiently illuminated floor, in connection with gait or balance disorder, dizziness, agitation or taking particular medicines. The most frequent results of falls were head injuries, hematomas, skin abrasions and lacerations. Less than 10% of falls required intervention of a family doctor, ambulance or hospitalization. In NHs for psychiatric patients the falls more often resulted in injuries, took place outside the facility building, and were connected to psychomotor agitation, taking psychotropic and anticonvulsant medicines. In NHs for elderly and chronically ill people, on the other hand, falls during sitting down and connected to taking cardiological medicines were recorded more frequently. The fall registration chart, developed within the EUNESE project, is a tool that allows to provide a detailed description of the incident: the cause of the fall, its course and consequences. It may also be used as a starting point for elaborating internal systems of fall registration in long term care facilities, as well as preventive measures against the falls.