Selective restraints and reduced medication could reduce nursing home falls says 4-year study

Jan 14, 2008

Selectively restraining elderly residents and giving them fewer sleeping pills could significantly reduce falls, according to a survey of 21 nursing home units published in the January issue of Journal of Clinical Nursing.

The four-year study, led by the Karolinska Institutet, Sweden, analysed 2,343 reported falls and fractures in five municipal homes to find out how they related to fall risk assessments and the use of safety belts, wheelchairs and sleeping pills.

Researchers analysed incidents affecting 743 males and 1,908 females ranging from 40 to 105 years of age, with an average age of 72. All had been diagnosed with a physical illness or dementia and some suffered from both.

The researchers found that people using certain drugs were much more likely to experience a fall. Sleeping pills and anti-depressants made people 1.4 times more likely to fall, neuroleptics (antipsychotic drugs) made them 1.9 times more likely and sleeping pills with benzodiazepines (sedatives) made them 2.9 times more likely.

“In Sweden the use of medication has increased during the past ten years” explains lead author Edit Fonad RN MNSc from the Department of Neurobiology at the Institutet.

“Nine per cent of the population are aged 75 years or more, yet this group accounts for a quarter of the medication prescribed in the country. On average, this age group consumes six to 10 different types of medication.”

People who were in wheelchairs, or who had been assessed as a fall risk, were much less likely to fall. The fall risk was assessed as 0.7, with 1.0 being the normal average. Bed rails reduced this risk even further to 0.5 and the risk when belts were used was negligible at 0.09.

“Patients are often restrained for reasons that remain unclear and more often as a matter of routine rather than a reaction to a specific situation” says Edit Fonad. “These actions are often justified by concerns for patient safety or behaviour control.”

However, the authors point out that in using restraints healthcare professionals should take into account the need to maintain the patients’ independence if possible and the fact that restraints can themselves cause injuries.

“It is impossible to prevent every single fall and we cannot rule out the fact that freedom-restricting measures will continue to be used in the care of older people” concludes Edit Fonad.

“Our results suggests that freedom-restricting actions cannot eliminate falls totally, but they might be protective when used selectively with fewer sedatives, especially benzodiazepines.”

Source: Blackwell Publishing Ltd.

Explore further: ALS Ice Bucket Challenge arrives in North Korea

add to favorites email to friend print save as pdf

Related Stories

Informing NASA's Asteroid Initiative: A citizen forum

Aug 28, 2014

In its history, the Earth has been repeatedly struck by asteroids, large chunks of rock from space that can cause considerable damage in a collision. Can we—or should we—try to protect Earth from potentially ...

Study shows social welfare may fall in a more ethical market

Aug 25, 2014

For "credence services" such as auto-repair, healthcare, and legal services, the benefit to the customers for the service is difficult to assess before and even after the service. A new study in a journal of the Institute ...

Invasive insect threatens iconic Florida citrus

Aug 24, 2014

The tourists stream to Florida in their cars, intent on a week at Disney or a sugar-sand seashore or a nonstop party on South Beach. Road weary and thirsty, they pull over at one of the state's five official ...

Recommended for you

Humiliation tops list of mistreatment toward med students

27 minutes ago

Each year thousands of students enroll in medical schools across the country. But just how many feel they've been disrespected, publicly humiliated, ridiculed or even harassed by their superiors at some point during their ...

Surrogate offers clues into man with 16 babies

8 hours ago

When the young Thai woman saw an online ad seeking surrogate mothers, it seemed like a life-altering deal: $10,000 to help a foreign couple that wanted a child but couldn't conceive.

Nurses go on strike in Ebola-hit Liberia

9 hours ago

Nurses at Liberia's largest hospital went on strike on Monday, demanding better pay and equipment to protect them against a deadly Ebola epidemic which has killed hundreds in the west African nation.

ALS Ice Bucket Challenge arrives in North Korea

Aug 31, 2014

It's pretty hard to find a novel way to do the ALS Ice Bucket Challenge by now, but two-time Grammy-winning rapper Pras Michel, a founding member of the Fugees, has done it—getting his dousing in the center ...

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

User comments : 0