Vital Resources for Reducing Fall-Related Emergency Department Transfers

Resources in nursing home (NHs) such as clinical training, geriatric expertise, and access to diagnostic equipment were identified by researchers as essential in reducing potentially avoidable fall-related hospital transfers to the emergency department (ED).

For this study, researchers identified unplanned fall-related hospital transfers over 21 months across 11 Swiss NHs. A total of 81 fall-related transfers were rated for avoidability by a 2-round expert panel.

According to results, 25% of transfers were deemed potentially avoidable. Furthermore, researchers found a positive association between an ED visit and a rating of avoidability (χ² (1, N = 81) = 18.0, P < .001).

A structured discussion with NH stakeholders on key implementable resources for NHs to utilize to potentially avoid fall-related transfers was also included in the study.

“Fourteen resources, including developing partnerships with outpatient clinics to access imaging services and strengthening geriatric expertise in nursing homes through clinical training and advanced nurse practitioners, were rated as appropriate by NH stakeholders for NH implementation to reduce potentially avoidable fall-related ED transfers,” stated study authors.

“Implementing and supporting advanced practice nurses or nurses in extended roles provides NH directors, policymakers, and health care institutions with the possibility of re-engineering resources to limit unnecessary transfers, which are detrimental for resident quality of care and costly for the health system,” concluded study authors.

Reference:
Guerbaai RA, Kressig RW, Zeller A, et al. Identifying appropriate nursing home resources to reduce fall-related emergency department transfers. J Am Med Dir Assoc. Published online February 19, 2022. doi:10.1016/j.jamda.2022.01.063.