title: Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial.
abstract: OBJECTIVE
  This article is a report of a randomized controlled trial to examine the effectiveness of a targeted multiple intervention strategy in reducing the number of patient falls in an acute care hospital.
  
  
  BACKGROUND
  Prevention of patient falls remains a challenge that has eluded healthcare institutions. The effectiveness of targeted multiple fall prevention interventions in reducing the incidences of falling has not been established.
  
  
  METHODS
  Patients who scored 5 and above on the Hendrich II Fall Risk Model, a fall assessment tool, were recruited in 2006. Patients who were randomized to the intervention group received targeted multiple interventions. Both the research groups received the standard fall prevention interventions from the ward nurses. The rates of fall incidences for both groups were reported with 95% CI, calculated using Wilson method and compared using the Chi-square test. The relative risk was estimated and 95% CI was calculated using the methods described by Armitage and Berry. The times to first fall events were constructed using the Kaplan-Meier method. The hazard ratio was reported at 95% CI and the comparison was made using the log-rank test.
  
  
  RESULTS
  There were 912 and 910 participants in the control and intervention groups, respectively. The fall incidence rates were 1·5% (95% CI: 0·9-2·6) and 0·4% (95% CI: 0·2-1·1) in the control and intervention groups, respectively. The relative risk estimate of 0·29 (95% CI: 0·1-0·87) favours the intervention group.
  
  
  CONCLUSIONS
  This study showed that targeted multiple interventions were effective in reducing the incidences of falls in patients in the acute care setting.
authors.affiliation: National University Cancer Institute Singapore, National University Health System, Singapore. emily_nk_ang@nuhs.edu.sg
authors.forename: Emily
authors.initials: E
authors.lastname: Ang
authors.forename: Siti Zubaidah
authors.initials: SZ
authors.lastname: Mordiffi
authors.forename: Hwee Bee
authors.initials: HB
authors.lastname: Wong
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D015400:Clinical Nursing Research; D005260:Female; D006760:Hospitalization; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D010347:Patient Care Planning; D010353:Patient Education as Topic; D018570:Risk Assessment / Q000379:methods; D017751:Safety Management / Q000379:methods*; D012846:Singapore