title: Preoperative patient education reduces in-hospital falls after total knee arthroplasty.
abstract: BACKGROUND
  Inpatient hospital falls after orthopaedic surgery represent a major problem, with rates of about one to three falls per 1000 patient days. These falls result in substantial morbidity for the patient and liability for the institution.
  
  
  OBJECTIVE
  We determined whether preoperative patient education reduced the rate of in-hospital falls after primary TKA and documented the circumstances and the injuries resulting from the falls.
  
  
  METHODS
  We reviewed data from all 244 patients who underwent primary TKA at a single institution between March and November 2009. Seventy-two patients of one surgeon were enrolled in a preoperative nurse-led education program. This group was compared with a control group of 172 patients who concurrently underwent TKA at the same institution but did not receive preoperative education.
  
  
  RESULTS
  More control patients had in-hospital falls than those in the education group: seven (one of whom had two falls) of 172 (4%) versus none of 72 (0%), respectively. Three of the eight falls resulted in a serious injury, including one wound dehiscence and one wound hematoma that both required repeat surgery and one clavicle fracture.
  
  
  CONCLUSIONS
  Inpatient falls after TKA may be associated with major complications. Our preoperative patient education reduced these falls and is now mandatory for patients undergoing TKA at our institution.
authors.affiliation: Department of Orthopedic Surgery, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ 85054, USA. clarke.henry@mayo.edu
authors.forename: Henry D
authors.initials: HD
authors.lastname: Clarke
authors.forename: Vickie L
authors.initials: VL
authors.lastname: Timm
authors.forename: Brynn R
authors.initials: BR
authors.lastname: Goldberg
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hattrup
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D016730:Program Development; D015397:Program Evaluation; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment