Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital
- PMID: 18332052
- PMCID: PMC2287238
- DOI: 10.1136/bmj.39499.546030.BE
Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital
Abstract
Objective: To determine the efficacy of a targeted multifactorial falls prevention programme in elderly care wards with relatively short lengths of stay.
Design: Cluster randomised trial.
Setting: 24 elderly care wards in 12 hospitals in Sydney, Australia.
Participants: 3999 patients, mean age 79 years, with a median hospital stay of seven days.
Interventions: A nurse and physiotherapist each worked for 25 hours a week for three months in all intervention wards. They provided a targeted multifactorial intervention that included a risk assessment of falls, staff and patient education, drug review, modification of bedside and ward environments, an exercise programme, and alarms for selected patients.
Main outcome measure: Falls during hospital stay.
Results: Intervention and control wards were similar at baseline for previous rates of falls and individual patient characteristics. Overall, 381 falls occurred during the study. No difference was found in fall rates during follow-up between intervention and control wards: respectively, 9.26 falls per 1000 bed days and 9.20 falls per 1000 bed days (P=0.96). The incidence rate ratio adjusted for individual lengths of stay and previous fall rates in the ward was 0.96 (95% confidence interval 0.72 to 1.28).
Conclusion: A targeted multifactorial falls prevention programme was not effective among older people in hospital wards with relatively short lengths of stay.
Trial registration: Australian New Zealand Clinical Trials Registry ACTRNO 12605000467639.
Conflict of interest statement
Competing interests: None declared.
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Comment in
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Preventing falls among older people in hospital: Results are not surprising.BMJ. 2008 Apr 19;336(7649):847. doi: 10.1136/bmj.39549.489896.3A. BMJ. 2008. PMID: 18420668 Free PMC article. No abstract available.
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Preventing falls among older people in hospital: Interpreting the null result.BMJ. 2008 Apr 19;336(7649):847. doi: 10.1136/bmj.39549.430162.3A. BMJ. 2008. PMID: 18420669 Free PMC article. No abstract available.
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A multifactorial intervention did not prevent falls or fractures in elderly patients during short hospital stays.Evid Based Nurs. 2008 Oct;11(4):120. doi: 10.1136/ebn.11.4.120. Evid Based Nurs. 2008. PMID: 18815332 No abstract available.
References
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- Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 2006;(4):CD0003402. - PubMed
-
- Vassallo M, Azeem T, Pirwani MF, Sharma JC, Allen SC. An epidemiological study of falls on integrated general medical wards. Int J Clin Pract 2000;54:654-7. - PubMed
-
- Vassallo M, Sharma JC, Briggs RS, Allen SC. Characteristics of early fallers on elderly patient rehabilitation wards. Age Ageing 2003;32:338-42. - PubMed
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