Fall prevention in residential care: a cluster, randomized, controlled trial.
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.
Kerse
Ngaire
N
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. n.kerse@auckland.ac.nz
Butler
Meg
M
Robinson
Elizabeth
E
Todd
Maree
M
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