Management Team Perceptions of Risks and Strategies for Preventing Falls Among Short-Stay Patients in Nursing Homes.

Journal Article (Journal Article)

We sought to understand strategies reported by members of the nursing home management team used to prevent falls in short-stay nursing home patients. Using Donabedian's model of structure, process, and outcomes, we interviewed 16 managers from 4 nursing homes in central North Carolina. Nursing home managers identified specific barriers to fall prevention among short-stay patients including rapid changes in functional and cognitive status, staff unfamiliarity with short-stay patient needs and patterns, and policies impacting care. Few interventions for reducing falls among short-stay patients were used at the structure level (eg, specialized units, workload ratio, and staffing consistency); however, many process-level interventions were used (eg, patient education on problem solving, self-care/mobility, and safety). We described several barriers to fall prevention among short-stay patients in nursing homes. From these descriptions, we propose three interventions that might reduce falls for short-stay patients and could be tested in future research: (1) clustering short-stay patients within a physical location to permit higher staff-patient ratios and enhanced surveillance, (2) population-based prevention interventions to supplement existing individually tailored prevention strategies (eg, toileting schedules, medication review for all), and (3) transitional care interventions that transmit key information from hospitals to nursing homes.

Full Text

Duke Authors

Cited Authors

  • Cary, MP; Hall, RK; Anderson, AL; Burd, A; McConnell, ES; Anderson, RA; Colón-Emeric, CS

Published Date

  • 2018

Published In

Volume / Issue

  • 37 / 1

Start / End Page

  • 76 - 85

PubMed ID

  • 29266090

Pubmed Central ID

  • PMC5777903

Electronic International Standard Serial Number (EISSN)

  • 1550-512X

Digital Object Identifier (DOI)

  • 10.1097/HCM.0000000000000192


  • eng

Conference Location

  • United States