Evaluation of a falls prevention programme in an acute tertiary care hospital.
OBJECTIVE
To evaluate a systematic, coordinated approach to limit the severity and minimize the number of falls in an acute care hospital.


BACKGROUND
Patient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them.


METHODS
A before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients' risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site.


RESULTS
In this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1-10), 58% (n = 774) medium risk (score = 11-20) and 5% (n = 63) high risk (score = 21-33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0.95 to 0.80 (95% CI for the difference -0.14 to -0.16, P < 0.001).


CONCLUSIONS
We evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions.


CONCLUSIONS
Preventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls.
Williams
Teresa A
TA
Centre for Nursing Evidence Based Nursing, Education & Research, Royal Perth Hospital, Perth, WA, Australia. williams@cyllene.uwa.edu.au
King
Gail
G
Hill
Anne-Marie
AM
Rajagopal
Maha
M
Barnes
Tina
T
Basu
Anita
A
Pascoe
Graeme
G
Birkett
Katherine
K
Kidd
Heather
H
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D015984:Causality; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D010347:Patient Care Planning / Q000458:organization & administration*; D015397:Program Evaluation; D018570:Risk Assessment / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*; D014904:Western Australia