I11 Towards a fall-friendly HD-nursing home?
Background Huntington Center Topaz Overduin offers long term care for 72 (advanced) HD-patients. The policy is to preserve the autonomy of these patients in order to maximise the quality of life. One of the consequences is that there is no use of restraints in any form, thereby accepting the fact that HD-patients fall frequently. With a multidisciplinary team of physicians, nurses, physiotherapists, dietician, occupational therapists and psychologists we do try to minimise the number and consequence of the falls. We need more information on the location, time and consequences of these falls, in order to improve our fall-friendly policy.
Aim To study the number, time, location and consequences of falls in institutionalised advanced HD- patients.
Methods Staff is mandated to register every fall on a standardised form, containing (among others) time, place and consequence of the fall. Retrospectively the forms from 2010 to 2011 were analysed.
Results In 2010 962 falls were reported, in 2011 this number decreased to 615. In more than 70% of the falls there were no consequences at all, only once a fracture was reported. Most of the falls happened in the bedroom, but the amount of falls did not differ very much between the periods of the day: morning afternoon, evening and nighttime. The 10 HD-patients with the most falls in 2010 and 2011 were responsible for 73% of all falls.
Conclusion It seems justified not to use restraints, but to respect the autonomy of the HD-patient with a fall-friendly policy.