Grant Detail
This is a chronological listing of grants held by this department, with the most recent listed first. New grants appear in this list weekly and contribute related to the department's Research Profile. The source of grants for this application comes directly from your institution.
Implementing a Program to Prevent Injurious Falls in Assisted Living
Sheryl Zimmerman; Carol Giuliani; Mary McClurg; Philip Sloane
9/15/2006 - 3/31/2010| Sponsoring Organization: | Research Triangle Institute (RTI International) |
| Awarding Organization Is: | University of North Carolina at Chapel Hill |
| Funding: | $ 49,999.00 |
Carol A Giuliani (Investigator)
Mary Roth McClurg (Investigator)
Philip David Sloane (Investigator)
Sheryl I Zimmerman (Lead Principal Investigator)
Falls are the primary cause of fracture, the significance of which is that fracture results in reduced function and quality of life, and increased morbidity and mortality. Risk factors for falls include history of falls, increased age, muscle weakness, gait deficit, balance deficit, use of assistive devices, visual deficits, arthritis, depression, cognitive impairment, medications (e.g., polypharmacy; lanoxin, type IA antiarrythmics, diuretics, neuroleptics, sedatives), and the environment. This problem is especially relevant in assisted living settings, because this population exhibits risk factors for falls; their rate of fracture is similar to that in nursing homes (101 per 1000 person-years); and assisted living staff are motivated to reduce falls becaue it improves care, outcomes, and reduces transfer. Fortunately, evidence-based interventions exist to reduce falls, including assessment followed by individualized recommendations focusing on postural hypotension, polypharmacy, balance, transfer, and gait. Despite successful interventions in the community and nursing homes, however, limited interventions exist in assisted living. Successful interventions must be tailored for this setting, given the nature of the population and practice differences between this and nursing homes (e.g., monthly pharmacy review is not mandated and physical therapists are not regularly available, as is the case in nursing homes). Therefore, the aims of this project are as follows: 1. Using a model of quality improvement and adapting evidence-based interventions that have been used in nursing home and community settings, develop a multi-component intervention program of medication review, assessment, environmental modification, and exercise, to reduce risk factors for falls and fall and fracture rates among residents of assisted living facilities. 2. Within two pairs of matched assisted living facilities, randomly select one of each to receive the multi-component intervention program, and the other to receive an educational intervention, and over the course of one year of implementation, determine: a. related to implementation: the degree to which the facility changes its practices in accordance with the multi-component intervention; the degree to which residents accept and adhere to the intervention; and facility- and resident-level facilitators for and obstacles to implementation and maintenance of the intervention b. related to outcomes: change in resident risk factors, and in facility fall and fracture rates c. related to implementation and outcomes: the relationship of implementation and adherence to change in risk factors and fall and fracture rates
