Feature articleContractures in Frail Nursing Home Residents
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Design, Participants, and Setting
This study was a descriptive correlational design using secondary data collected in an intervention study conducted in 4 medium-sized (range: 120–235 beds) nursing homes in the metropolitan Philadelphia area.14, 15 First, observation methods were used to evaluate restrictive siderail usage in each nursing home. All residents identified with restrictive siderails (defined as 2 full-length or 4 half-length raised siderails) at baseline were eligible to participate in the primary study. A total of
Results
The mean age of all residents in the sample was 83.69 years (SD = 9.39). The majority were female (72%) and White (69%), and their payor source was Medicaid (65%). Table 1 presents the prevalence of contractures. A total of 480 contractures were identified. Over 60% of the sample (n = 167) had at least 1 contracture, with 45.4% having 2 or more contractures. The most frequent joints affected were the shoulder (44%) and the knee (44%).
Table 2 compares demographic, physical and mental health
Discussion
This study identified a high prevalence of contractures among nursing home residents—twice the national average reported by Harrington and colleagues.1 The participants in this study were selected based on siderail use for the primary study14 and thus represent cognitively aware residents who were still functionally able to transfer in and out of bed and also included cognitively impaired residents who were at risk for falls. Because this study did not follow individuals over time from
Acknowledgments
This study was funded by the John A. Hartford Foundation Building Academic Geriatric Nursing Capacity Scholars Program, the John A. Hartford Foundation Institute for Geriatric Nursing, and NOVARTIS Foundation for Gerontological Research.
LAURA M. WAGNER, PhD, RN, GNP-BC, is a gerontological nursing research scientist at Kunin-Lunenfeld Applied Research Unit at Baycrest, Toronto, Ontario, Canada.
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LAURA M. WAGNER, PhD, RN, GNP-BC, is a gerontological nursing research scientist at Kunin-Lunenfeld Applied Research Unit at Baycrest, Toronto, Ontario, Canada.
ELIZABETH CAPEZUTI, PhD, RN, FAAN, GNP-BC, is an associate professor and the codirector of the John A. Hartford Foundation Institute for Geriatric Nursing, New York University College of Nursing, New York, New York.
BARBARA L. BRUSH, PhD, RN, FAAN, APN-BC, is an associate professor and co-coordinator of the family nurse practitioner program, Health Promotion and Risk Reduction Programs, University of Michigan School of Nursing, Ann Arbor.
CAROLYN CLEVENGER, DNP, RN, GNP-BC, is a clinical assistant professor, Emory University School of Nursing, Atlanta, Georgia.
MARIE BOLTZ, PhD, RN, GNP-BC, is an assistant professor and practice director, The Hartford Institute for Geriatric Nursing, New York University College of Nursing, New York, New York.
SUSAN RENZ, MSN, RN, GNP-BC, is a consultant in gerontology and long-term care, RS Connection, Inc. West Chester, Pennsylvania.