April 25, 2017
According to an article currently in press at JAMDA, emergency evacuations of residents at nursing facilities seem to have a negative effect on resident mortality in the 6 months following evacuation procedures (doi: 10.1016/j.jamda.2017.02.005).
In order to investigate the associated survival risk of nursing home (NH) residents within 6 months following emergency evacuations, due to man-made or natural disasters, researchers from Australia conducted a systematic review of publications between January 1, 2000 and December 31, 2015.
Publications included peer-reviewed studies in English, French, German, or Spanish that examined mortality within the 6 months following a disaster evacuation from a NH. Information analyzed included population characteristics, risk factors, and mortality measures. The disaster management cycle was used to examine the studies as well, which considers preparedness, response, recovery, and mitigation.
Disaster Preparedness for Long-Term Care Facilities
Critical Review of Transitional Care Between Nursing Homes and Emergency Departments
Ten studies were included; they were published between 2010 and 2015 and half were conducted in the United States. Three studies discussed the preparedness stage; 4 detailed the response stage. Measured as an indicator of recovery, mortality was found to be elevated at 1 month [from 0.03% (n = 1088) to 10.5% (n = 75)] 3 months [from 0.08% (n = 3091) to 15.2% (n = 197)], and 6 months [from 14.9% (n = 263) and 16.8% (n = 22)] postevacuation compared with pre-evacuation and sheltering-in-place. Residents over the age of 80, frail, dependent, or male with multiple comorbidities were shown to be vulnerable residents.
Researcher said it was surprising that they found so little research on the impact of emergency evacuation on NH residents given the greater mortality risk postevacuation. They noted that evacuation, independent of the effect of the disaster, seems to have a negative effect on resident survival. Based on these findings, they note that “standard evacuation procedures may be less applicable to this vulnerable population because of the extra challenges they face in disasters.”—Amanda Del Signore