Prevalence of falls with minor and major injuries and their associated factors among older adults in long-term care facilities.

Aims and objectives.  The objectives of this study were to determine the prevalence of falls with minor and major injuries and identify their risk factors. Background.  Falls among residents of long-term care facilities (LTCF) constitute a significant health issue. Design.  This is a secondary analysis of a cross-sectional study carried out among older people (n = 2332). Methods.  This is a descriptive study focusing on the secondary analysis of a cross-sectional study carried out with a group of older people (n = 2332) in 28 LTCF in Quebec City, Canada. Research assistants collected original data for each resident from two sources: structured simultaneous interviews with two nurses per unit from each of the homes and a review of the residents' medical files. Results.  7.2% of subjects had a fall leading to minor injuries and 10.1% a fall leading to major injuries. Risk factors associated with fall-related minor injury are young age, male gender and cognitive impairment. Factors associated with fall-related major injury were functional autonomy and length of stay. In further statistical analysis, controlling for functional autonomy, disruptive behaviours and neuroleptic use were found associated with fall-related major injury. Conclusions.  This study demonstrates that the factors associated with fall-related minor injury are different from those associated with fall-related major injury. Relevance to clinical practice.  This study suggests that nurses working with LTCF residents who are concerned about the prevention of fall-related major injury, may contribute to a reduction in such falls through optimal management of behavioural problems and neuroleptic use.