title: Evaluation of a falls prevention programme in an acute tertiary care hospital.
abstract: 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.
authors.affiliation: Centre for Nursing Evidence Based Nursing, Education & Research, Royal Perth Hospital, Perth, WA, Australia. williams@cyllene.uwa.edu.au
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Williams
authors.forename: Gail
authors.initials: G
authors.lastname: King
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Hill
authors.forename: Maha
authors.initials: M
authors.lastname: Rajagopal
authors.forename: Tina
authors.initials: T
authors.lastname: Barnes
authors.forename: Anita
authors.initials: A
authors.lastname: Basu
authors.forename: Graeme
authors.initials: G
authors.lastname: Pascoe
authors.forename: Katherine
authors.initials: K
authors.lastname: Birkett
authors.forename: Heather
authors.initials: H
authors.lastname: Kidd
mesh_terms: 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