Comparison of a fall risk assessment tool with nurses' judgement alone: a cluster-randomised controlled trial.
BACKGROUND
the impact of fall risk assessment tools on clinical endpoints is unknown.


OBJECTIVE
we compared a standardised fall risk assessment tool alongside nurses' clinical judgement with nurses' judgement alone.


METHODS
a 12-month cluster-randomised controlled trial.


METHODS
nursing homes in Hamburg (29 per study group).


METHODS
1,125 residents (n = 574 intervention group, IG; n = 551 control group, CG).


METHODS
all homes received structured information on fall prevention before randomisation. The IG monthly administered the Downton Index, and the CG did not use a tool. Measurements were number of participants with at least one fall, falls, fall-related injuries and medical attention, fall preventive measures, physical restraints.


RESULTS
the mean follow-up was 10.8 +/- 2.9 months in both groups: 105 (IG) and 114 (CG) residents died or moved away. There was no difference between the groups concerning the number of residents with at least one fall (IG: 52%, CG: 53%, mean difference -0.7, 95% confidence interval -10.3 to 8.9, P = 0.88) and the number of falls (n = 1,016 and n = 1,014). All other outcomes were also comparable between the IG and CG.


CONCLUSIONS
application of a fall risk assessment tool in nursing homes does not result in the better clinical outcome than reliance on nurses' clinical judgement alone.
Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany. Gabriele.Meyer@uni-wh.de
Gabriele
G
Meyer
Sascha
S
Köpke
Burkhard
B
Haastert
Ingrid
I
Mühlhauser
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D016000:Cluster Analysis; D015577:Geriatric Assessment; D005858:Germany; D006801:Humans; D015994:Incidence; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012112:Residential Facilities / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D018709:Statistics, Nonparametric