A Review of Falls And Injuries Of Nursing Home Residents Presenting To The Emergency Department.

Abstract

Background: Falls are frequently reported within the HSE. The Irish Longitudinal Study on Ageing(TILDA) found that 40% of over 50 s experience a fall in a two year period, with 20% requiring hospital attendance (1). It has been estimated that the cost of injuries related to falls in older people will increase exponentially over the coming years (2). There is no national database in Ireland with statistics for nursing home(NH) residents presenting with falls to our Emergency Departments(ED).

Aim: To review the prevalence and risk factors for nursing home patients presenting to the Emergency Department with falls.

Design: Retrospective chart review.

Method: Retrospective review of all NH presentations to the ED of a university hospital over one year.

Results: There were 519 ED presentations by NH residents over one year. 48.17% (n = 250), presented with a fall. One third of ED visits presented during conventional working hours. Falls patients were more likely to be admitted when not reviewed by a G.P. prior to presentation. The average length of stay for falls admissions was 10.77 days(n = 132), vs 9.56(n = 153) for admissions with no documented fall. There was no statistical difference in the falls risk medications between groups. Patients presenting with falls were more likely to have bone protection reviewed during their stay(P=.011). Patients with falls were also more likely to use mobility aids(P < 0.001).

Conclusion: Rapid referral to falls prevention programmes and the use of standardised care pathways for high falls risk patients are essential for future prevention and management.