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.
Meyer
Gabriele
G
Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany. Gabriele.Meyer@uni-wh.de
Köpke
Sascha
S
Haastert
Burkhard
B
Mühlhauser
Ingrid
I
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