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The introduction of Senior Alert – process and patient outcomes in preventive work in Swedish nursing homes

2018 Conference Presentation

Residential Care Sweden

10 September 2018

The introduction of Senior Alert – process and patient outcomes in preventive work in Swedish nursing homes

Christina Lannering, Länssjukhuset Ryhov, Sweden


Background: Healthcare professionals using Senior Alert may be supported in their work to prevent adverse events such as falls and pressure ulcers and the development of malnutrition, by using Senior Alert - an evidence based tool for preventive work.

Objective: The aim was to investigate how the introduction of the Senior Alert programme has affected process and patient outcomes.

Method: This was a descriptive study based on quality registry data from Senior Alert. Comparison was made between two groups of nursing home residents (N=1103) included in the registry, in 2010–2012 (N=567) and 2013–2014 (N=536) respectively. Process outcome were calculated as the percentage of persons with risk for whom preventive actions were recorded and who were followed up with weight and with new assessments. Patient outcomes were calculated as the percentage of persons with pressure ulcers, fall events and weight loss within 6 months after the assessment. This timeframe was chosen with consideration to quality aspects of care in this group of frail older persons.

Results: In the group included to the registry during 2010–2012 approximately 60% of the residents received individual planned actions to prevent falls, pressure ulcers or malnutrition, respectively. Corresponding value for the later included group was 75%. For persons with risk for malnutrition in the earlier group, 30% were followed up with weight. In the later included group this percentage was 44%. A new risk assessment was performed for 20% in the earlier group and for 30% in the later included group. No statistical significant difference between the groups was seen regarding patient outcomes like weight-loss with at least 5 % (~17%), fall events (19%) or pressure ulcers (3%). Measurement of these outcomes was hampered because of the low percentage of follow-up together with poor event registrations for falls.

Conclusion: An evidence base way to work may take some time to be established, which motivated the comparison of two groups included in the registry at different time periods. Though higher process results in the later included group, still rather few were followed-up on weight and were reassessed within the determined timeframe. This may be seen as a quality problem in this frail group. Poor event registration in combination with low follow-up limited the measures of patient outcomes as the samples became small. This stress the need of fixed time points for follow-up. This would decline the effect of differences in views on how to use SA, and thereby improve the possibility to use data for research and comparison.