A Profile of Calls from Nursing Homes to a Poison Center

Background: There are few data which describe the nature of poisoning exposures or calls to poison centers that involve the residents of nursing homes (NH). The objective of this study was to profile the most common exposures that occurred in NH residents so that appropriate interventions could be developed. Methods: A retrospective analysis of calls over an eight year period (2000-2007) from NH to a regional poison information center was conducted. The data were analyzed for age, gender, substance, reason, acuity, treatment, outcome and disposition. Results: Over the study period there were 1,738 (mean 217.25/year) calls from NH. Two-thirds were females (age: 81.7 plus or minus 7.8; 60-99) and the remainder were males (age: 78.5 plus or minus 8.3; 60-97). Unintentional exposures accounted for 86.5% of the calls. Referral to a health care facility was unnecessary in 97.7%. More than one-half of those who were referred were treated and released. No fatalities occurred. Therapeutic errors accounted for 8.6 % of the calls. The most common reasons were talcing or being given someone else's medication (65.5%). Discussion: Most calls from NH were unintentional exposures. NH residents are vulnerable to unintentional poisoning or adverse medication reactions due to their innate frailty, co-morbidity factors, and being prescribed multiple medications. Males, although representing only a quarter of NH residents, accounted for one-third of exposed persons in nursing homes. Therapeutic errors were slightly higher in NH residents in comparison to the general population, but much lower than in geriatric non-NH residents. Given the large number of NH residents, it was surprising that the related call volume to the poison center was not larger. Conclusion: Understanding the circumstances, agents and the scenarios that are responsible for NH poisoning exposures will provide guidance to develop education and prevention programs that are evidence-based strategies to decrease the number of unintentional exposures and therapeutic errors. Furthermore, it appears that the poison center must make greater efforts in creating awareness of poison center services to nursing home personnel.