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
• 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
Services, and identified out of bed collaboration with the engineering, nursing, physical and
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
Ambulating Bed Chair Toilet Transfer Unknown
Location of Falls
Bathroom 4% 3%
Jewish Geriatric Services
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
• 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.