Especially in a nursing home setting, accidents leading to occasional injuries are inevitable. In order to prevent these occurrences, nursing home facilities should implement injury prevention techniques to ensure that these accidents are avoided when possible. Injury prevention techniques can be incorporated on several levels. Specialized staff training, resident therapy, and family education can contribute to injury prevention for nursing home residents. Emergency plans for handling accidents can also reduce the severity of injuries and improve long-term outcomes for those who are injured. Elder injury prevention is vital for the care of our nations seniors.
Proper Resident Care
In many cases, injury prevention may begin by ensuring that each resident receives adequate care and attention. Neglect and lack of attention are often contributors to nursing home injuries, such as falls and bedsores. The level of care required for each resident primarily depends on the resident’s physical and mental wellbeing. Those who are less capable of maintaining daily functioning may be more susceptible to nursing home injuries.
To help in injury prevention, nursing facilities should ensure that staff members are properly trained and qualified for the position they hold within the facility. For example, registered nurses are often required to hold between two and six years of nursing education. However, these requirements vary by state. Lack of experience and training in nursing home staff members can be a significant contributor to resident injuries.
According to the journal Injury Prevention, elderly falls are roughly three times more common in residential settings such as nursing homes than in the general community. The CDC states that the most effective fall prevention techniques are multidisciplinary and systematic. Fall prevention may be implemented at several levels, including organizational, staff, and patient levels.
Injury prevention for nursing home falls may include:
- Assessing patients for risk factors and medical conditions which may contribute to falls
- Educating staff members about risk factors and prevention methods
- Changing the nursing home environment, such as grab bar installation, raising toilet seats, and lowering bed heights
- Providing resident exercise programs that may improve strength, balance, and physical functioning
- Educating mentally capable residents about behavioral strategies to help prevent falls
Statistics show that physical restraints generally do not help to prevent nursing home falls. Adversely, the CDC reports that routine use of physical restraints may actually contribute to fall-related injury and death. Physical restraints may also cause muscle weakness and a decrease in the patient’s physical function. This may contribute to the long-term risk of fall injuries. The CDC urges that restraints should not be used as a fall prevention technique.
Research shows that the older an individual, the more likely he or she is to develop infections. Likewise, the older the individual, the less capable his or her body is in fighting against these infections. Nursing home patients are commonly susceptible to developing infections. This is especially true for residents who are immobile or who have restricted movement. These residents are typically less able to provide daily hygiene and care, such as bathing and grooming. In cases of incontinence, these residents may rely solely on nursing home staff members to maintain clean and sanitary living conditions.
Due to the close nature of a nursing home, failure to practice sanitation, hygiene, and disease prevention may result in the spread of infections among nursing home residents and staff members. Common airborne infections include pneumonia, influenza, and tuberculosis. Federal and state laws require that nursing home facilities have certain procedures in place to treat infected patients and limit the opportunity these infections have to spread to other nursing home residents.
Wound infections are particularly common among immobilized patients. Bedsores are a type of wound that can develop in immobile patients who are not regularly turned and moved in their beds throughout the day. In severe cases, bedsores can lead to sepsis and death. If residents exhibit signs and symptoms of bedsores, medical attention should be administered as soon as possible. All wounds should be sterilized regularly. Depending on the type of injury, dressings should be applied and changed regularly. Some patients may require antibiotics for severe infections.
D’Arcy, Laura, P., Yasuko Sasai, and Sally, C. Stearns. “Do Assistive Devices, Training, and Workload Affect Injury Incidence? Prevention Efforts by Nursing Homes and Back Injuries among Nursing Assistants.” Journal of Advanced Nursing 68.4 (2012): 836-845. CINAHL Plus with Full Text. Web. 1 Mar. 2014.
Neufeld, Richard R., Leslie S. Libow, and William J. Foley. “Restraint Reduction Reduces Serious Injuries among Nursing Home Residents.” Journal of the American Geriatrics Society 47.10 (1999): 1202-1207. Social Sciences Full Text (H.W. Wilson). Web. 1 Mar. 2014.
Porell, Frank, W., and Mary, W. Carter. “Risk of Mortality and Nursing Home Institutionalization after Injury.” Journal of the American Geriatrics Society 60.8 (2012): 1498-1503. CINAHL Plus with Full Text. Web. 1 Mar. 2014.