Thursday, 1 June 2017

Preventable nursing home deaths increase four-fold in 11 years


It is estimated that by the mid-2050s Australia’s population will be 31-43 million, 25% of whom will be aged 65 years or more. With this in mind, understanding nursing home quality and safety is becoming increasingly important.

In a major study published in the Medical Journal of Australia, SPHPM’s Professor Joseph Ibrahim and co-authors at the Victorian Institute for Forensic Medicine have found that the number of preventable deaths in Australian nursing homes quadrupled between 2001 and 2012. They’ve used the data as a reason to call for policy and practice changes in aged care.
Deaths in nursing homes had not been quantified in Australia prior to the study. By state laws, deaths resulting from violence or injury must be reported to the coroner’s office for investigation. The team used reported coronial data arising from nursing homes as the source of their analysis.

The annual number of deaths from external causes, including injuries, falls and suicides, rose from 1.2 per 1000 admissions in 2001-02 to 5.3 per 1000 admissions in 2011-12. From an injury prevention viewpoint, it is notable that most non-natural causes of deaths of nursing home residents were related to falls (81.5%), choking (7.9%) and suicide (4.4%).

The researchers believe the rate increase is partly due to improved reporting practices in Victorian nursing homes, particularly with regards to deaths from falls. However, they believe more can be done to address the knowledge gap and reveal a more accurate number of preventable deaths.

Professor Ibrahim told The Guardian,

“People get used to the idea that people get old and then die. Whenever you’re asked as a doctor you assume that it’s natural causes. People tend not to look as closely into the death.”

The authors called for a structured approach to improving quality of care in nursing homes that incorporated a ‘systems’ approach. This uses the principles applied in aviation and health care to reduce adverse events.

The study concludes by observing that the data challenges the misperception that all deaths of frail, older people living in residential care are natural. The authors warned against negative or dismissive value judgements about the worth of an older person’s life.

You can read coverage in The Guardian here

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