title: The 6-PACK programme to decrease falls and fall-related injuries in acute hospitals: protocol for an economic evaluation alongside a cluster randomised controlled trial.
abstract: BACKGROUND
  Falls are a common hospital occurrence complicating the care of patients. From an economic perspective, the impact of in-hospital falls and related injuries is substantial. However, few studies have examined the economic implications of falls prevention interventions in an acute care setting. The 6-PACK programme is a targeted nurse delivered falls prevention programme designed specifically for acute hospital wards. It includes a risk assessment tool and six simple strategies that nurses apply to patients classified as high-risk by the tool.
  
  
  OBJECTIVE
  To examine the incremental cost-effectiveness of the 6-PACK programme for the prevention of falls and fall-related injuries, compared with usual care practice, from an acute hospital perspective.
  
  
  METHODS
  The 6-PACK project is a multicentre cluster randomised controlled trial (RCT) that includes 24 acute medical and surgical wards from six hospitals in Australia to investigate the efficacy of the 6-PACK programme. This economic evaluation will be conducted alongside the 6-PACK cluster RCT. Outcome and hospitalisation cost data will be prospectively collected on approximately 16,000 patients admitted to the participating wards during the 12-month trial period. The results of the economic evaluation will be expressed as 'cost or saving per fall prevented' and 'cost or saving per fall-related injury prevented' calculated from differences in mean costs and effects in the intervention and control groups, to generate an incremental cost-effectiveness ratio (ICER).
  
  
  CONCLUSIONS
  This economic evaluation will provide an opportunity to explore the cost-effectiveness of a targeted nurse delivered falls prevention programme for reducing in-hospital falls and fall-related injuries. This protocol provides a detailed statement of a planned economic evaluation conducted alongside a cluster RCT to investigate the efficacy of the 6-PACK programme to prevent falls and fall-related injuries.
  
  
  BACKGROUND
  The protocol for the cluster RCT is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000332921).
authors.affiliation: The Centre for Research Excellence in Patient Safety, Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. renata.morello@monash.edu
authors.forename: Renata
authors.initials: R
authors.lastname: Morello
authors.forename: Anna
authors.initials: A
authors.lastname: Barker
authors.forename: Silva
authors.initials: S
authors.lastname: Zavarsek
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Watts
authors.forename: Terry
authors.initials: T
authors.lastname: Haines
authors.forename: Keith
authors.initials: K
authors.lastname: Hill
authors.forename: Cathie
authors.initials: C
authors.lastname: Sherrington
authors.forename: Caroline
authors.initials: C
authors.lastname: Brand
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
authors.forename: Just
authors.initials: J
authors.lastname: Stoelwinder
mesh_terms: D000058:Accidental Falls / Q000191:economics / Q000517:prevention & control*; D001315:Australia; D002985:Clinical Protocols; D016000:Cluster Analysis; D003362:Cost-Benefit Analysis; D005260:Female; D006757:Hospital Units / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000191:economics; D011314:Preventive Health Services / Q000191:economics*; D018570:Risk Assessment / Q000191:economics; D016037:Single-Blind Method; D014947:Wounds and Injuries / Q000191:economics / Q000451:nursing / Q000517:prevention & control*