Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial

Area of Science:

• Geriatric medicine
• Healthcare quality improvement
• Implementation science

Background:

• Falls are a major geriatric syndrome requiring effective interventions.
• Complex interventions in nursing homes face implementation challenges.
• Existing falls quality improvement programs need enhanced implementation strategies.

Purpose of the Study:

• To evaluate if a complexity science-based staff training intervention (CONNECT) improves the effectiveness of an evidence-based falls quality improvement program (FALLS).
• To assess the impact of enhanced staff interactions on fall prevention and resident safety in nursing homes.

Main Methods:

• A cluster-randomized trial involving 24 nursing homes was conducted.
• The intervention group received CONNECT training followed by FALLS, while the control group received FALLS alone.
• Data collected included staff surveys on communication and safety climate, and resident medical records on fall risk reduction, falls, and injurious falls.

Main Results:

• Neither the intervention nor the control group showed improvement in documented fall risk reduction activities.
• Recurrent fall rates did not differ significantly between the groups.
• A modest improvement in staff communication quality and timeliness was observed in the intervention group, with wide variation in intervention uptake.

Conclusions:

• The CONNECT intervention, aimed at improving staff communication, did not enhance the impact of the FALLS program on fall prevention.
• Current approaches to implementing complex interventions for geriatric syndromes in nursing homes require further development.
• Evidence-based care implementation for complex conditions in long-term care settings necessitates innovative strategies.