Delirium Screening to Prevent Falls in the Long-term Care Setting

Abstract

Background

Nearly 30 million people fall in the United States (U.S.) every year with 20% resulting in serious injury. These incidents disproportionately occur in the elderly population. Of the 1.6 million people living in long-term care (LTC) settings in the U.S., between 50-75% experience a fall annually with many experiencing multiple falls. This population is 2 times as likely to experience such an event – and due to increased age, they are least likely to recover. Delirium, a main contributing factor to fall, has been found to go undetected in as many as 66% of individuals in the clinical setting.

Method

A randomized sample group (N = 22) was observed over an 8-week period (T-1) in which weekly delirium screening was performed using the Simple Query for Easy Evaluation of Consciousness (SQeeC) in a LTC facility. Fall data was recorded and compared to results obtained over the previous 8-week period (T-2) in which quarterly delirium screening with the Confusion Assessment Method (CAM) was performed using an independent sample t-test to determine the impact of weekly screening on fall rates.

Results

During T-1, there were 12 falls. Of these, 1 was a delirium-related fall. In T-2, there were 16 falls with 4 being delirium-related. The mean fall/week in T-1 was 1.5 compared to 2.0 in T-2. There was not a statistically significant difference in falls (p=0.475) when using the SQeeC.

Conclusion

Though not statistically significant, there was an apparent clinical difference evidenced by a decrease in the number of falls, falls per week, and delirium-related falls. This may be attributable to increased awareness and vigilance throughout the time of the project. Further work is needed to make a determination.