Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital.
OBJECTIVE
To determine the efficacy of a targeted multifactorial falls prevention programme in elderly care wards with relatively short lengths of stay.


METHODS
Cluster randomised trial.


METHODS
24 elderly care wards in 12 hospitals in Sydney, Australia.


METHODS
3999 patients, mean age 79 years, with a median hospital stay of seven days.


METHODS
A nurse and physiotherapist each worked for 25 hours a week for three months in all intervention wards. They provided a targeted multifactorial intervention that included a risk assessment of falls, staff and patient education, drug review, modification of bedside and ward environments, an exercise programme, and alarms for selected patients.


METHODS
Falls during hospital stay.


RESULTS
Intervention and control wards were similar at baseline for previous rates of falls and individual patient characteristics. Overall, 381 falls occurred during the study. No difference was found in fall rates during follow-up between intervention and control wards: respectively, 9.26 falls per 1000 bed days and 9.20 falls per 1000 bed days (P=0.96). The incidence rate ratio adjusted for individual lengths of stay and previous fall rates in the ward was 0.96 (95% confidence interval 0.72 to 1.28).


CONCLUSIONS
A targeted multifactorial falls prevention programme was not effective among older people in hospital wards with relatively short lengths of stay.


BACKGROUND
Australian New Zealand Clinical Trials Registry ACTRNO 12605000467639.
Cumming
Robert G
RG
School of Public Health, University of Sydney, Sydney, Australia. bobc@health.usyd.edu.au
Sherrington
Catherine
C
Lord
Stephen R
SR
Simpson
Judy M
JM
Vogler
Constance
C
Cameron
Ian D
ID
Naganathan
Vasi
V
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D016000:Cluster Analysis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D009517:New South Wales; D009732:Nursing Care / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data