Citation

Teresi JA, Ramirez M, Remler D, Ellis J, Boratgis GD, Silver S, Lindsey M, Kong J, Eimicke JP, Dichter E. Int. J. Nurs. Stud. 2013; 50(4): 448-463.

Affiliation

Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471, United States; Columbia University Stroud Center, Faculty of Medicine and New York State Psychiatric Institute, 100 Haven Avenue, Tower III, 30F, New York, NY 10471, United States; Weill Medical College of Cornell University, Department of Geriatrics, Faculty of Medicine, 1300 York Avenue, New York, NY 10065, United States.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.ijnurstu.2011.07.003

PMID

21807366

Abstract

OBJECTIVES: The aim was to conduct a comparative effectiveness research study to estimate the effects on falls, negative affect and behavior, and the associated societal costs of implementing evidence-based education and best practice programs in nursing homes (NHs). DESIGN: A quasi-experimental design, a variant of a cluster randomized trial of implementation research examining transfer of research findings into practice, was used to compare outcomes among three groups of residents in 15 nursing homes per group. METHODS: Forty-five NHs participated in one of three conditions: (1) standard training, (2) training and implementation modules provided to facility staff, or (3) staff training and implementation modules augmented by surveyor training. After application of exclusion and matching criteria, nursing homes were selected at random within three regions of New York State. Outcomes were assessed using medical records and the Minimum Data Set (MDS). RESULTS: The main finding was of a significant reduction of between 5 and 12 annual falls in a typical nursing home. While both intervention groups resulted in fall reduction, the larger and significant reduction occurred in the group without surveyor training. A significant reduction in negative affect associated with training staff and surveyors was observed. Net cost savings from fall prevention was estimated. CONCLUSIONS: A low cost intervention targeting dissemination of evidence-based best practices in nursing homes can result in the potential for fall reduction, and cost savings.

Language: en