title: Reducing serious fall-related injuries in acute hospitals: are low-low beds a critical success factor?
abstract: OBJECTIVE
  This article is a report of a study of associations between occurrence of serious fall-related injuries and implementation of low-low beds at The Northern Hospital, Victoria, Australia.
  
  
  BACKGROUND
  A 9-year evaluation at The Northern Hospital found an important reduction in fall-related injuries after the 6-PACK falls prevention program was implemented. Low-low beds are a key component of the 6-PACK that aims to decrease fall-related injuries.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  Retrospective audit of The Northern Hospital inpatients admitted between 1999-2009. Changes in serious fall-related injuries throughout the period and associations with available low-low beds were analysed using Poisson regression.
  
  
  RESULTS
  During the observation of 356,158 inpatients, there were 3946 falls and 1005 fall-related injuries of which 60 (5·9%) were serious (55 fractures and five subdural haematomas). Serious fall-related injuries declined significantly throughout the period. When there was one low-low bed to nine or more standard beds there was no statistically significant decrease in serious fall-related injuries. An important reduction only occurred when there was one low-low bed to three standard beds.
  
  
  CONCLUSIONS
  The 6-PACK program has been in place since 2002 at The Northern Hospital. Throughout this time serious fall-related injuries have decreased. There appears to be an association between serious fall-related injuries and the number of available low-low beds. Threshold numbers of these beds may be required to achieve optimal usability and effectiveness. A randomized controlled trial is required to give additional evidence for use of low-low beds for injury prevention in hospitals.
authors.affiliation: Centre of Research Excellence in Patient Safety, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. anna.barker@monash.edu.au
authors.forename: Anna
authors.initials: A
authors.lastname: Barker
authors.forename: Jeannette
authors.initials: J
authors.lastname: Kamar
authors.forename: Tamara
authors.initials: T
authors.lastname: Tyndall
authors.forename: Keith
authors.initials: K
authors.lastname: Hill
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D001315:Australia; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000517:prevention & control*