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Health care sciences and services
Methodology Seventeen nursing homes in Ireland were recruited to take part in this research.Ownership varies with seven private homes and ten Health Service Executive (HSE) administered homes involved. The homes were surveyed between May 2007 andNovember 2008. The methodology consisted of the following three elements: A building survey to establish fire safety facilities: An analysis of fire related documentation: Interviews with staff to establish existing fire safety procedures. Results None of the seventeen nursing homes showed an adequate ability to prevent fire or evacuate residents to a place of safety. None of the nursing homes carried out adequate fire risk assessments. None of the nursing homes prevented fire doors being left open. Only one nursing home fully complied with relevant codes of practice in terms of construction and required fire safety facilities. Only one nursing home had a sufficient standard of compartmentation to allow the movement of residents to a relatively safer part of the building to await rescue. However there were positive results such as the fact that all the homes had adequate automatic fire detection and alarm and emergency lighting systems installed and had carried out tests and maintenance on these systems to some extent. One home had routinely carried out all these required tests. Escape routes were found to be clear of obstructions and the standard of storage was high. Staff had received training in fire safety and they were found to be motivated and receptive to improving fire prevention and evacuation. Sample frame extrapolation The number of nursing homes surveyed in this research was 17. This represents a small percentage (0.03%) of the overall number of nursing homes in Ireland (approximately 586). This presents statistical difficulties when attempting to extrapolate to the rest of the country. Until a follow up survey using the same methodology is carried out on a representative sample of national nursing homes, it is not possible to predict if the research sample performance is replicated throughout Ireland. However it should be remembered that the results apply to the 17 nursing homes in question and in this regard are statistically significant for that sample (p=<0.05). Speculating on the extrapolation accuracy is therefore far too difficult to achieve meaningful conclusions. However the findings of the research should not be ignored on the basis that national fire safety performance cannot be assessed. Whilst the research did not set out to achieve national representation, the results should still be theoretically applied to Ireland given the potential scale of injury and fatalities due to inadequate fire safety management. Recommendations A larger sample of nursing homes needs to be surveyed using the same methodology to statistically assess the scale of the problem. A standardised fire risk assessment methodology and evacuation protocol should be adopted and all staff in nursing homes trained to this standard. Research is needed on the ratio of staff to residents required for successful evacuation together with a cost benefit analysis on the use of sprinklers. There is a need for a memorandum of understanding between relevant Government Departments to establish responsibility for the effective enforcement of fire safety management and evacuation procedures in Irish nursing homes.