(HealthDay)—An intervention targeting gaps in staff communication and coordination (complexity science-based staff training intervention [CONNECT]) does not improve the impact of an evidence-based falls quality improvement program (FALLS), according to a study published online Oct. 2 in JAMA Internal Medicine.
Cathleen S. Colón-Emeric, M.D., from Duke University Medical Center in Durham, North Carolina, and colleagues conducted a cluster-randomized trial in 24 nursing homes receiving CONNECT followed by FALLS (intervention) or FALLS alone (control). Nursing home staff completed surveys at baseline as well as three, six, and nine months; 1,545 staff members completed surveys (734 [37 percent] and 811 [44 percent] of eligible staff in intervention and control facilities, respectively). Medical records were abstracted for 1,794 residents with at least one fall in the six-month pre- and post-intervention windows.
The researchers found that after FALLS, neither the CONNECT nor the FALLS-only facilities improved the mean count of fall reduction activities (3.3 versus 3.2 of 10); there was no difference between the groups in the adjusted median recurrent fall rates (4.06 versus 4.06 falls/resident/year). Overall, staff communication measures (mean, 0.03 points on a five-point scale) and communication timeliness (mean, 0.8 points on a five-point scale) improved modestly. Wide variation was seen across facilities in intervention penetration.
"New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed," the authors write.
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