Organizational and staff attitudinal determinants of falls in nursing home residents

Falls are the second leading cause of accidental death in the U.S., with the elderly suffering 75% of these accidents. Previous research has primarily focused on the relationship between personal factors such as medical diagnosis, medications, physiologic changes, mental alertness, environmental hazards, and falls among the elderly. The potentially important roles of organizational and staff attitudinal determinants, the foci of this study, have received little previous research attention. Specifically, leadership, work group cohesion, job involvement, attitudes toward the elderly, and job expectations were related to falls in 12 Veterans Administration (VA) nursing homes in New York, Ohio, and Pennsylvania. Data analysis reveals that these organizational and staff attitudinal factors account for 25% of the variance (P less than 0.05) in this sample. Unlike the majority of other institutional studies, in this VA sample, there was no significant correlation between medical diagnoses, length of stay, mental alertness of the residents, and number of falls. The implications of this study for preventing falls in long-term care facilities are discussed.