Gait speed and adverse events in nursing home residents: A prospective cohort study

Samantha Fien, Michael Climstein, T Henwood, Evelyne Rathbone, Justin W L Keogh

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Falls, wounds and hospitalisation are serious adverse events that may result in reduced independence and quality of life, and contribute to higher risks of disability and death in nursing homes. Objectives: To quantify the incidence of events (falls, hospital admissions and wounds) in nursing home residents and to determine if gait speed thresholds can predict falls. Design: A prospective cohort design was used to estimate the incidence and types of adverse events. Setting: Three nursing homes on the Gold Coast/Northern New South Wales, Australia. Participants: 100 nursing home adults consented to participate in this project. Measurements: The primary outcome included the number of adverse events (falls, wounds and hospital admissions) accessed through the nursing homes records. We used negative binomial regression models adjusted for potential confounders to examine associations between gait speed group and falls suffered by residents in nursing home settings, and we reported incidence rate ratios (IRRs) with 95% CIs and the actual P-value. Results: During the six months, there were a total of 226 falls, 243 wounds, 65 hospital admissions and 29 deaths with 12% of the residents having a fall(s), wound, admitted to hospital and dying in the 6-month period. Gait speed was not a statistically significant factor that impacted adverse events. However, for every additional hospital admission there was a 28% increased rate of falling, for every additional wound there was a 7.8% increased rate of falling and for every kilogram increase in handgrip strength there was a 4.4% increase rate of falling. Residents were also found to have an increased rate of falling if they were female (65.5%) and a decreased rate of falling with a positive impairment Mini-Cog score residents were likely to have a 52% decrease in their rate of falling when compared with negative cognitive impairment. Conclusion: The incidence of adverse events in Australian nursing homes is high, suggesting that continual refinement of assessment, education, awareness and management processes are required to improve resident outcomes. In particular, falls reduction interventions appear important, as they would likely reduce the number of hospital admissions and wounds in the nursing home setting.
Original languageEnglish
Pages (from-to)81-87
Number of pages8
JournalThe Journal of Nursing Home Research
DOIs
Publication statusPublished - 2017

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Nursing Homes
Cohort Studies
Prospective Studies
Wounds and Injuries
Incidence
Nursing Records
Ghana
South Australia
New South Wales
Walking Speed
Statistical Models
Hospitalization
Quality of Life
Education

Cite this

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title = "Gait speed and adverse events in nursing home residents: A prospective cohort study",
abstract = "Background: Falls, wounds and hospitalisation are serious adverse events that may result in reduced independence and quality of life, and contribute to higher risks of disability and death in nursing homes. Objectives: To quantify the incidence of events (falls, hospital admissions and wounds) in nursing home residents and to determine if gait speed thresholds can predict falls. Design: A prospective cohort design was used to estimate the incidence and types of adverse events. Setting: Three nursing homes on the Gold Coast/Northern New South Wales, Australia. Participants: 100 nursing home adults consented to participate in this project. Measurements: The primary outcome included the number of adverse events (falls, wounds and hospital admissions) accessed through the nursing homes records. We used negative binomial regression models adjusted for potential confounders to examine associations between gait speed group and falls suffered by residents in nursing home settings, and we reported incidence rate ratios (IRRs) with 95{\%} CIs and the actual P-value. Results: During the six months, there were a total of 226 falls, 243 wounds, 65 hospital admissions and 29 deaths with 12{\%} of the residents having a fall(s), wound, admitted to hospital and dying in the 6-month period. Gait speed was not a statistically significant factor that impacted adverse events. However, for every additional hospital admission there was a 28{\%} increased rate of falling, for every additional wound there was a 7.8{\%} increased rate of falling and for every kilogram increase in handgrip strength there was a 4.4{\%} increase rate of falling. Residents were also found to have an increased rate of falling if they were female (65.5{\%}) and a decreased rate of falling with a positive impairment Mini-Cog score residents were likely to have a 52{\%} decrease in their rate of falling when compared with negative cognitive impairment. Conclusion: The incidence of adverse events in Australian nursing homes is high, suggesting that continual refinement of assessment, education, awareness and management processes are required to improve resident outcomes. In particular, falls reduction interventions appear important, as they would likely reduce the number of hospital admissions and wounds in the nursing home setting.",
author = "Samantha Fien and Michael Climstein and T Henwood and Evelyne Rathbone and Keogh, {Justin W L}",
year = "2017",
doi = "10.14283/jnhrs.2017.13",
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}

Gait speed and adverse events in nursing home residents : A prospective cohort study. / Fien, Samantha; Climstein, Michael; Henwood, T; Rathbone, Evelyne; Keogh, Justin W L.

In: The Journal of Nursing Home Research, 2017, p. 81-87.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Gait speed and adverse events in nursing home residents

T2 - A prospective cohort study

AU - Fien, Samantha

AU - Climstein, Michael

AU - Henwood, T

AU - Rathbone, Evelyne

AU - Keogh, Justin W L

PY - 2017

Y1 - 2017

N2 - Background: Falls, wounds and hospitalisation are serious adverse events that may result in reduced independence and quality of life, and contribute to higher risks of disability and death in nursing homes. Objectives: To quantify the incidence of events (falls, hospital admissions and wounds) in nursing home residents and to determine if gait speed thresholds can predict falls. Design: A prospective cohort design was used to estimate the incidence and types of adverse events. Setting: Three nursing homes on the Gold Coast/Northern New South Wales, Australia. Participants: 100 nursing home adults consented to participate in this project. Measurements: The primary outcome included the number of adverse events (falls, wounds and hospital admissions) accessed through the nursing homes records. We used negative binomial regression models adjusted for potential confounders to examine associations between gait speed group and falls suffered by residents in nursing home settings, and we reported incidence rate ratios (IRRs) with 95% CIs and the actual P-value. Results: During the six months, there were a total of 226 falls, 243 wounds, 65 hospital admissions and 29 deaths with 12% of the residents having a fall(s), wound, admitted to hospital and dying in the 6-month period. Gait speed was not a statistically significant factor that impacted adverse events. However, for every additional hospital admission there was a 28% increased rate of falling, for every additional wound there was a 7.8% increased rate of falling and for every kilogram increase in handgrip strength there was a 4.4% increase rate of falling. Residents were also found to have an increased rate of falling if they were female (65.5%) and a decreased rate of falling with a positive impairment Mini-Cog score residents were likely to have a 52% decrease in their rate of falling when compared with negative cognitive impairment. Conclusion: The incidence of adverse events in Australian nursing homes is high, suggesting that continual refinement of assessment, education, awareness and management processes are required to improve resident outcomes. In particular, falls reduction interventions appear important, as they would likely reduce the number of hospital admissions and wounds in the nursing home setting.

AB - Background: Falls, wounds and hospitalisation are serious adverse events that may result in reduced independence and quality of life, and contribute to higher risks of disability and death in nursing homes. Objectives: To quantify the incidence of events (falls, hospital admissions and wounds) in nursing home residents and to determine if gait speed thresholds can predict falls. Design: A prospective cohort design was used to estimate the incidence and types of adverse events. Setting: Three nursing homes on the Gold Coast/Northern New South Wales, Australia. Participants: 100 nursing home adults consented to participate in this project. Measurements: The primary outcome included the number of adverse events (falls, wounds and hospital admissions) accessed through the nursing homes records. We used negative binomial regression models adjusted for potential confounders to examine associations between gait speed group and falls suffered by residents in nursing home settings, and we reported incidence rate ratios (IRRs) with 95% CIs and the actual P-value. Results: During the six months, there were a total of 226 falls, 243 wounds, 65 hospital admissions and 29 deaths with 12% of the residents having a fall(s), wound, admitted to hospital and dying in the 6-month period. Gait speed was not a statistically significant factor that impacted adverse events. However, for every additional hospital admission there was a 28% increased rate of falling, for every additional wound there was a 7.8% increased rate of falling and for every kilogram increase in handgrip strength there was a 4.4% increase rate of falling. Residents were also found to have an increased rate of falling if they were female (65.5%) and a decreased rate of falling with a positive impairment Mini-Cog score residents were likely to have a 52% decrease in their rate of falling when compared with negative cognitive impairment. Conclusion: The incidence of adverse events in Australian nursing homes is high, suggesting that continual refinement of assessment, education, awareness and management processes are required to improve resident outcomes. In particular, falls reduction interventions appear important, as they would likely reduce the number of hospital admissions and wounds in the nursing home setting.

U2 - 10.14283/jnhrs.2017.13

DO - 10.14283/jnhrs.2017.13

M3 - Article

SP - 81

EP - 87

JO - The Journal of Nursing Home Research

JF - The Journal of Nursing Home Research

SN - 2496-0799

ER -