The nursing staff's opinion of falls among older persons with dementia. a cross-sectional study

BMC Nursing

Inger Johansson³  Randi Slaasletten²  Marie Louise Hall-Lord³  Margareta Bachrach-Lindström¹  Solveig Struksnes² 

[1] Associate Professor, Faculty of Health Sciences, Department of Medicine and Care, Division of Nursing Science, Linköping University, 58183 Linköping, Sweden;Associate professor, Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, 2815 Gjövik, Norway;Faculty of Social and Life Sciences, Karlstad University, 65188 Karlstad, Sweden

关键词: older persons;    nursing care;    nursing home;    falls;    Dementia;   

Others  :  1109692
DOI  :  10.1186/1472-6955-10-13

 received in 2010-09-01, accepted in 2011-06-20,  发布年份 2011

【 摘 要 】

The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs) and enrolled nurses (ENs) and staff with ≤5 and >5 years of employment in the care units in question.

Background

Falls are common among older people and persons with dementia constitute an additional risk group.

Methods

The study had a cross-sectional design and included nursing staff (n = 63, response rate 66%) working in four special care units for older persons with dementia. Data collection was conducted with a questionnaire consisting of 64 questions.

Results

The respondents reported that the individuals' mental and physical impairment constitute the most frequent causes of falls. The findings also revealed a lack of, or uncertainty about, routines of documentation and reporting fall-risk and fall-preventing interventions. Respondents who had been employed in the care units more than five years reported to a higher degree that colours and material on floors caused falls. RNs considered the residents' autonomy and freedom of movement as a cause of falls to a significantly higher degree than ENs. RNs also reported a significantly longer time than ENs before fall incidents were discovered, and they used conversation and closeness as fall-preventing interventions to a significantly higher degree than ENs.

Conclusions

Individual factors were the most common causes to falls according to the nursing staff. RNs used closeness and dialog as interventions to a significantly higher degree to prevent falls than ENs. Caring of for older people with dementia consisted of a comprehensive on-going assessment by the nursing staff to balance the residents' autonomy-versus-control to minimise fall-risk. This ethical dilemma should initiate development of feasible routines of systematic risk-assessment, report and documentation.

【 授权许可】

   
2011 Struksnes et al; licensee BioMed Central Ltd.

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