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					                                                                         Assessment and Redesign of Environment to Reduce Fall Risk
                                                                          Marc Santos*, Sheila Pennell*, Cynthia Jacelon** PhD RN CRRN-A, and Dr. Sundar Krishnamurty**
                                                                                   University of Massachusetts Amherst, *Undergraduate Researcher, **Faculty

                                              Abstract                                                                                                                                                Research Objectives
       This research is an interdisciplinary effort to critically examine the contribution of the
physical environment to resident fall risk at the Jewish Nursing Home in Longmeadow, MA.                                                                                   • Determine the contribution of the physical and work environment to
An examination of falls data concludes that falls from the residents’ bed are most common                                                                                    resident fall risk at the Jewish Geriatric Services (JGS) Nursing Home in
within the facility, which is consistent with the national average. This project inspects falls out                                                                          Longmeadow, MA.
of bed (OOB). Data consists of staff interviews, chart reviews, analysis of the facility layout,
critical examination of current nursing interventions for fall prevention, and a review of                                                                                 • Examine current evidence base for current fall prevention practice in
literature on preventing injury during falls out of bed. The resulting research determined that                                                                              long term care facilities.
current nursing interventions within the facility are drawn from collective wisdom and
tradition rather than from the current evidence base. The nursing dimension of the research                                                                                • To identify elements within the resident bedroom whose design could be
examines current literature supporting or refuting the commonly practiced interventions for                                                                                  improved to reduce resident injury and provide a more ergonomic
OOB falls in an effort to bring current evidence into practice at the facility. The engineering                                                                              environment.
dimension focuses on an assessment of the resident bedroom environment to investigate
potential hazards. In addition a modular and ergonomic air-bed mattress intervention is                                                                                    • Use incident tracking to evaluate the fall intervention communication
designed to replace the current use of standard mattresses in fall prevention. All solutions                                                                                 cycle and implementation.
and recommendations for the Jewish Nursing Home are strengthened through knowledge
and experience drawn from the College of Engineering and School of Nursing collaboration.

                     Progress and Results
                                                                                                                                         Interdisciplinary Connections
 • We have performed a literature
   review of available journals and                                                                                     • The study was designed to be a collaboration between the
   related articles pertaining to patient                                                                                 Assistive Technologies Laboratory in the College of
   falls, environmental hazards, and                                                                                      Engineering and the School of Nursing.
   ergonomic redesign for the elderly.
                                                                                                                        • The research was funded by the Hluchyi family, alumni of the
 • We completed a chart review and                                                                                        college of Engineering and School of Nursing.
   database assessment for resident
   falls     data at Jewish Geriatric                                                                                   • Data collection and intervention investigation incorporated
                                                                                                                                                                                                                     Standard Resident
   Services, and identified out of bed                                                                                    collaboration with the engineering, nursing, physical and
                                                                                                                                                                                                                       Room Layout
   falls as our primary concern.                                                                                          occupational therapy, social work, staff education, and facility
                                                                                                                          maintenance departments at Jewish Geriatric Services.
 • We modeled a resident room and
   bed to identify problematic areas,
   and developed a redesign option for
   the bedside mattress fall intervention.

                                            Resident Activity Prior to Fall

                                            Unknown
                                              3%
                                         Transfer
                                           0%
                                   Toilet                                                  Ambulating
                                    4%                                                       22%


        Chair
        33%




                                                                                         Bed
                                                                                         38%




                                Ambulating     Bed     Chair    Toilet   Transfer    Unknown



                                                     Location of Falls




                                            Other    Unknown
                     Bathroom                4%        3%
                       11%

      Dining Room
           8%




           Hallway
             8%
                                                                                                        Resident Room
                                                                                                             57%
                                                                                                                                                                                                                Jewish Geriatric Services
                      Lounge
                        8%
                             Shower
                               1%                                                                                                                                                                               Communication Diagram
           Resident Room        Shower      Lounge    Hallway    Dining Room        Bathroom   Other    Unknown



                                                                                                                                       Prototype of an Inflatable Air Mat System
      Breakdown of Nursing Home
                                                                                                                                         for the Prevention of Bed-fall Injuries
      Falls at JGS Jan 06’- Mar 07’                                                                                                                                                                      Current and Proposed Publications
                                                                                                                                      Current and Planned Industrial Collaboration              The Research efforts hope to resulted in the following
                                                Future Work
                                                                                                                                                                                                publications:
 • Assemble and finalize the prototype design                                                                                       The research study is in collaboration with the             Conference / Journal Papers
   to be presented as a cost-effective                                                                                              Jewish Geriatric Services Nursing Home in
   alternative to low beds and a ergonomic                                                                                                                                                      Assessment and Redesign of Environment to reduce Fall-
                                                                                                                                    Longmeadow, MA.                                             risk. To be submitted Fall 2007.
   and user friendly substitute for current
   bedside mat interventions.                                                                                                       The research Team attended and participated in
 • Redesign of current database programs to                                                                                         the Jewish Geriatric Services second annual
   facilitate patient tracking for evaluation of                                                                                    research Conference.                                        The Research Effort hopes to result in the following
   the falls program effectiveness.                                                                                                                                                             theses/dissertations:
                                                                                                                                    Results, suggestions, and designs will be
 • The JGS Scholar in Residence, Cynthia                                                                                            presented at the next Jewish Geriatric Services             Undergraduate Capstone Thesis:
   Jacelon PhD RN CRRN-A will continue to                                                                                           annual conference.                                          Assessment and Redesign of Environment to Reduce Fall-
   examine the falls practices at JGS in an                                                                                                                                                     risk, Student Two, Expected date of graduation: December
   overall effort to bring current evidence into                                                                                                                                                2007.
   practice at the facility.



                                                                                                       This work is supported by Michael G. Hluchyj '76 and Theresa (Murphy) Hluchyj '77.

                                                                                                       Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect those of the
                                                                                                       National Science Foundation.

				
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