title: Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people.
abstract: BACKGROUND
  falls disproportionately affect older people, who are at increased risk of falls and injury. This pilot study investigates shock-absorbing flooring for fall-related injuries in wards for frail older people.
  
  
  METHODS
  we conducted a non-blinded cluster randomised trial in eight hospitals in England between April 2010 and August 2011. Each site allocated one bay as the 'study area', which was randomised via computer to intervention (8.3-mm thick Tarkett Omnisports EXCEL) or control (2-mm standard in situ flooring). Sites had an intervention period of 1 year. Anybody admitted to the study area was eligible. The primary outcome was the fall-related injury rate. Secondary outcomes were injury severity, fall rate and adverse events.
  
  
  RESULTS
  during the intervention period, 226 participants were recruited to each group (219 and 223 were analysed in the intervention and control group, respectively). Of 35 falls (31 fallers) in the intervention group, 22.9% were injurious, compared with 42.4% of 33 falls (22 fallers) in the control group [injury incident rate ratio (IRR) = 0.58, 95% CI = 0.18-1.91]. There were no moderate or major injuries in the intervention group and six in the control group. The fall IRR was 1.07 (95% CI = 0.64-1.81). Staff at intervention sites raised concerns about pushing equipment, documenting one pulled back.
  
  
  CONCLUSIONS
  future research should assess shock-absorbing flooring with better 'push/pull' properties and explore increased faller risk. We estimate a future trial will need 33,480-52,840 person bed-days per arm.
authors.affiliation: School of Health Sciences and Social Work, University of Portsmouth, James Watson Building (West), 2 King Richard 1st Road, Portsmouth, Hampshire PO1 2FR, UK. amy.drahota@port.ac.uk
authors.forename: Amy Kim
authors.initials: AK
authors.lastname: Drahota
authors.forename: Derek
authors.initials: D
authors.lastname: Ward
authors.forename: Julie E
authors.initials: JE
authors.lastname: Udell
authors.forename: Dia
authors.initials: D
authors.lastname: Soilemezi
authors.forename: Reuben
authors.initials: R
authors.lastname: Ogollah
authors.forename: Bernard
authors.initials: B
authors.lastname: Higgins
authors.forename: Taraneh P
authors.initials: TP
authors.lastname: Dean
authors.forename: Martin
authors.initials: M
authors.lastname: Severs
mesh_terms: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D004739:England; D005260:Female; D005430:Floors and Floorcoverings; D006757:Hospital Units; D006801:Humans; D015601:Injury Severity Score; D007297:Inpatients; D008297:Male; D016017:Odds Ratio; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
keywords: 80 and over; aged; floors and floorcoverings; hospitals; older people; randomised controlled trial