title: Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial.
abstract: BACKGROUND
  falls and related injuries are known to be a significant problem for older people. There is evidence that identifying and addressing individual risk factors can reduce the incidence of falls in the community but no evidence of the effectiveness of targeted risk factor reduction methods applied to hospital in-patients.
  
  
  OBJECTIVE
  to test the efficacy of a targeted risk factor reduction core care plan in reducing risk of falling while in hospital.
  
  
  METHODS
  a group (ward) randomised trial.
  
  
  METHODS
  elderly care wards and associated community units of a district general hospital in the North of England.
  
  
  METHODS
  all elderly patients who received care in eight wards and community units during a 12-month study period.
  
  
  METHODS
  matched pairs of wards were randomly allocated to intervention or control groups. In the intervention wards, staff used a pre-printed care plan for patients identified as at risk of falling and introduced appropriate remedial measures. Numbers of falls in each group were then compared.
  
  
  RESULTS
  after introduction of the care plan there was a significant reduction in the relative risk of recorded falls on intervention wards (relative risk 0.79, 95% CI 0.65-0.95) but not on control wards (RR 1.12, 95% CI 0.96-1.31). The difference in change between the intervention wards and control wards was highly significant (RR 0.71, 95% CI 0.55-0.90, P = 0.006). There was no significant reduction in the incidence of falls-related injuries.
  
  
  CONCLUSIONS
  the use of a core care plan targeting risk factor reduction in older hospital in-patients was associated with a reduction in the relative risk of recorded falls.
authors.affiliation: Department of Elderly Medicine, York District Hospital, Wigginton Road, York YO31 8HE, UK. frances.healey@npsa.nhs.uk
authors.forename: Frances
authors.initials: F
authors.lastname: Healey
authors.forename: Andrew
authors.initials: A
authors.lastname: Monro
authors.forename: Angela
authors.initials: A
authors.lastname: Cockram
authors.forename: Vicki
authors.initials: V
authors.lastname: Adams
authors.forename: David
authors.initials: D
authors.lastname: Heseltine
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D006801:Humans; D007297:Inpatients; D010347:Patient Care Planning; D012308:Risk Management