Risk Factors for Evaluating the Quality of Nursing Home CareSkip to content

Nursing Homes Quality Care 

Published: Dec 30, 2022. Last Updated: Jan 8, 2023.

The quality of care provided in nursing homes is an important consideration for families looking for a safe and supportive living environment for their loved ones. To evaluate a nursing home, it is important to consider a range of risk factors that can provide insight into the level of care provided at the facility.

A nursing home is a type of residential care facility that provides long-term care and support for older adults who are unable to live independently due to physical or cognitive impairments. Nursing homes typically provide 24-hour medical and personal care, as well as recreational and social activities, for their residents.

There are many risk factors associated with poor-quality care in nursing homes. By being aware of these things, you can make better decisions about the type of care you want for your loved ones. These risk factors include:

  • UTI (urinary tract infection)
  • Pressure ulcer
  • Serious falls
  • Medication errors
  • Poor nutrition and dehydration
  • Poor hygiene
  • Restraints
  • Restricted access to the outdoors

UTI as a Risk Factor

Urinary tract infection (UTI) in nursing home residents can be a sign of poor quality care. UTIs are often caused by bacteria that enter the urinary tract through the urethra and can be prevented with proper hygiene and infection control measures. If nursing home staff do not provide regular hygiene or follow infection control protocol, residents may develop UTIs. Similarly, if residents are not monitored for catheter care and their catheters are not changed regularly, they may develop UTIs due to bacterial growth in the catheter.

Pressure Ulcer as A Risk Factor

A pressure ulcer, also known as a bed sore, is a type of wound that occurs when the skin and underlying tissue are damaged by constant pressure or friction. Pressure ulcers most commonly occur in areas of the body where the bone is close to the skin, such as the heels, ankles, hips, and tailbone. Symptoms of a pressure ulcer include red or discolored skin, swelling, pain, and an open wound or blister.

Pressure ulcers are mostly preventable when a resident is frequently monitored and turned, given the right support, and pressure relief. Without regular monitoring from nursing home staff, residents become more susceptible to developing pressure ulcers. Moreover, if a resident cannot move by themselves and the staff does not help with positioning them regularly, they will also have a greater chance of getting pressure sores.

Serious Falls as A Risk Factor

Serious falls are falls that result in significant injury, such as a broken bone, head injury, or loss of consciousness. These are common occurrences in nursing home residents due to factors such as poor mobility, medications that affect balance, and underlying medical conditions.

Residents in nursing homes who suffer serious falls are often an indication of poor quality care. Falls can be prevented through regular assessments of residents' mobility and risk factors for falling, as well as providing fall prevention measures such as grab bars and assistive devices. Failure to provide these services may increase the risk of serious falls.

Medication Errors as A Risk Factor

Any event that leads to the misuse of medicine or harms a patient is called a medication error. This can mean prescribing the wrong drug, giving too high or low of a dose, or giving the medication to someone it isn't meant for. Such errors often have severe repercussions like injury and death. By having an effective system for managing and administering medication, nursing homes could drastically reduce the number of medication errors their residents experience. This includes having a reliable and accurate system of recording, tracking, and dispensing medications, as well as providing adequate training for nursing home staff.

Poor Nutrition and Dehydration as A Risk Factor

Poor nutrition and dehydration are common issues among nursing home residents. Poor nutrition can lead to numerous physical and mental health problems such as weakened immunity, increased risk of infection, depressed mood, and difficulty with activities of daily living. Similarly, dehydration can cause fatigue, confusion, weakness, and a higher risk of falls.

Nursing homes have a responsibility to give their residents balanced, nutritious meals and make sure they stay hydrated throughout the day. Poor nutrition and dehydration are often preventable through regular monitoring of residents' food and fluid intake, as well as providing appropriate nutritional support and hydration.

Poor Hygiene as A Risk Factor

Lack of proper hygiene can lead to a whole host of health problems in nursing home residents, including infections, skin rashes and irritation, and an increased risk of falls. Poor hygiene can be caused by inadequate staffing levels, lack of access to bathing facilities, failure to provide necessary items such as soap and shampoo, or from neglecting to help residents with personal care tasks.

Nursing homes should ensure that their residents are properly cared for and are given the necessary items to maintain good hygiene standards. They should also provide sufficient staffing levels to help with bathing, dressing, and other personal care tasks as needed. Failure to do so may put residents at risk of poor hygiene and its associated health risks.

Restraints as A Risk Factor

Restraints are any device or medication that is used to restrict a person's freedom of movement or ability to communicate. Restraints can include physical restraints, such as restraints on the arms or legs, and chemical restraints, such as medication that sedates or calms the person. These can have serious consequences, including injury, falls, and loss of mobility.

They are often used in nursing homes as a means of preventing falls or managing difficult behaviors, but they can also cause harm if not used properly. If not adequately monitored, restraints can cause physical or psychological harm to residents. Nursing homes should only use restraints when absolutely necessary and never as a form of punishment. They should also have adequate staffing levels to monitor residents who are restrained and provide timely interventions if needed.

Restricted Access to The Outdoors as A Risk Factor

Restricted access to the outdoors refers to situations where residents are not able to leave the nursing home or go outside for regular physical activity and fresh air. This can lead to a lack of physical activity and exposure to natural light, which can have negative effects on physical and mental health. It can also lead to feelings of depression, isolation, and frustration.

Nursing homes should provide their residents with access to the outdoors as often as possible. This includes providing adequate staffing levels for outdoor activities and transportation if needed. They should also create an inviting environment for residents to enjoy, such as setting up comfortable seating areas and walking paths. Failure to provide adequate access to the outdoors is an indication of inadequate care and may put residents at risk of negative health outcomes.

How to Choose Nursing Home While Keeping These Risk Factors in Mind

You can take these following steps when choosing for nursing homes:

  • Research and compare nursing homes in your area. Look for information about the facilities, services, and staff, as well as any reports or ratings from government agencies or other organizations.
  • Visit the nursing homes you are considering and ask questions. Talk to the staff and residents, and observe the facility and the care provided.
  • Consider the risk factors when evaluating the nursing homes you are considering. Look for signs of UTI, pressure ulcer, serious falls, medication errors, poor nutrition and dehydration, poor hygiene, restraints, and restricted access to the outdoors.
  • Ask about the nursing home's policies and procedures for preventing and addressing these risk factors. Find out what measures the nursing home has in place to prevent them, and how they handle incidents when they occur.
  • Make your decision based on the information and observations you gather. Choose the nursing home that provides the highest quality care and has the lowest prevalence of the risk factors.

By following these steps and taking into consideration the risk factors, you will be able to make smart decisions about the best care options for your loved ones in nursing homes.

Related Articles

About the Author

Ericka Nicolas

Writer & Researcher

Elder Guide LLC

Ericka Nicolas began her career in the banking industry where she learned the importance of being detail-oriented and well-organized, both of which she applies to her current work as a writer and proofreader. With her vast experience in writing, Ericka is able to produce well-researched and engaging content that appeals to Elderguide's target audience. She was able to provide readers with valuable insights on a variety of topics and ensures that all the information she provides is accurate and up-to-date. She takes the time to carefully study each topic given to her, which allows her to produce truly informative articles. Ericka's passion for writing and her dedication to producing quality content gave way to her goal of helping our readers navigate the complex world of senior living and make informed decisions about their future. Aside from her work at Elderguide, Ericka enjoys spending time with her newly-married husband and their dog, Yari. She loves cooking, traveling, and exploring new restaurants in her spare time.