title: Fall prevention in residential care: a cluster, randomized, controlled trial.
abstract: OBJECTIVE
  To establish the effectiveness of a fall-prevention program in reducing falls and injurious falls in older residential care residents.
  
  
  METHODS
  Cluster, randomized, controlled trial.
  
  
  METHODS
  Fourteen randomly selected residential care homes in Auckland, New Zealand.
  
  
  METHODS
  All older residents (n=628, 95% participation rate).
  
  
  METHODS
  Residential care staff, using existing resources, implemented systematic individualized fall-risk management for all residents using a fall-risk assessment tool, high-risk logo, and strategies to address identified risks.
  
  
  METHODS
  Number of residents sustaining a fall, falls, and injurious-falls incidence rates.
  
  
  RESULTS
  During 12 months of follow-up, 103 (43%) residents in the control group and 173 (56%) residents in the intervention group fell (P<.018). There was a significantly higher incidence rate of falls in intervention homes than in control homes (incident rate ratio=1.34, 95% confidence interval=1.06-1.72) during the intervention period after adjusting for dependency level (type of home), baseline fall rate, and clustering. There was no difference in the injurious fall incidence rate or incidence of serious injuries.
  
  
  CONCLUSIONS
  This fall-prevention intervention did not reduce falls or injury from falls. Low-intensity intervention may be worse than usual care.
authors.affiliation: Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. n.kerse@auckland.ac.nz
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
authors.forename: Meg
authors.initials: M
authors.lastname: Butler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.forename: Maree
authors.initials: M
authors.lastname: Todd
mesh_terms: D000056:Accident Prevention; D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D016000:Cluster Analysis; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000193:education / Q000379:methods; D006801:Humans; D015994:Incidence; D007318:Inservice Training / Q000458:organization & administration; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D009728:Nursing Assistants / Q000193:education; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D009740:Nursing Staff / Q000193:education; D015397:Program Evaluation; D012112:Residential Facilities; D018570:Risk Assessment / Q000458:organization & administration; D012307:Risk Factors; D012308:Risk Management / Q000458:organization & administration*; D016037:Single-Blind Method