STUDY: Higher Nursing Home CNA Staffing Levels Associated with Lower Fall Rate

One out of five nursing home residents suffer a fall within one month of admission, but the risk of falling goes down if the facilities have higher certified nursing staffing levels, a new study found.

Researchers at the University of Southern California (USC) and Brown University examined the relationship between falls in newly admitted nursing home residents and nursing home organizational characteristics, including staffing, profit and chain status, number of beds, and presence of a special unit.

The study, published in the Journal of the American Geriatrics Society in June 2012, analyzes the 2006 Minimum Data Set (MDS) assessments of nearly 231,000 Medicare/Medicaid residents admitted to about 9,700 nursing homes for the first time.

For every one-hour increase in CNA hours per resident per day, there was a 3 percent decrease in falls, the researchers concluded. RN and LPN staffing was not found to be a significant predictor of falls.

The researchers explain that new residents are in an unfamiliar environment and not well known to the staff, making the identification and management of the risk for falls more challenging.

“This study highlights the different health care goals of a population striving to get back to the community, who were mostly admitted for rehabilitation after a hospital stay, relative to long-term patients who reside in the nursing home,” said Natalie Leland, a USC research gerontologist and occupational therapist and lead author of the study.

“A fall can delay or permanently prevent the patient from returning to the community, and identifying risk of falling is essential for implementing fall-prevention strategies and facilitating successful discharge back to the community,” Leland said.

The researchers suggest that increasing CNA staffing to provide assistance to residents during activities that put them at a greater risk for falls, such as toileting and transferring, could potentially prevent falls. CNAs provide the majority of hands-on care to residents and are with them during these higher-risk activities.

— by Deane Beebe