Ensuring evidence-based practices for falls prevention in a nursing home setting

Area of Science:

• Gerontology
• Healthcare Quality Improvement
• Patient Safety

Background:

• Falls are a significant risk for older adults in nursing homes.
• Effective falls prevention strategies require robust structural and process measures.
• Adherence to evidence-based recommendations for falls prevention is often suboptimal in long-term care settings.

Purpose of the Study:

• To assess the impact of a multifaceted quality improvement program on falls prevention.
• To improve structural elements, professional conduct, and patient outcomes related to falls.
• To evaluate the effectiveness of an internal quality improvement cycle in a nursing home setting.

Main Methods:

• An internal quality improvement cycle was implemented in a 130-resident nursing home in Spain.
• The program involved developing quality criteria, audit and feedback, and targeted educational interventions.
• Falls prevention quality was measured using evidence-based criteria, with fall incidence tracked over a year.

Main Results:

• Baseline falls prevention practices were found to be inadequate.
• Post-intervention, all structural criteria and 8 of 9 process criteria showed significant improvement.
• A significant reduction in the fortnightly incidence of falls was observed (32 falls pre-intervention vs. 21 post-intervention).

Conclusions:

• The internal quality improvement cycle effectively enhanced adherence to evidence-based falls prevention recommendations.
• The program led to significant improvements in both the structure and processes of falls prevention.
• The intervention successfully improved patient safety and reduced fall rates in the nursing home.