Intervention program reduced fall rate in hospitals

Dykes P. JAMA. 2010;304:1912-1918.

Hospital units that used a fall prevention tool kit experienced fewer patient falls than units that did not use the tool kits, according to researchers from the Partners HealthCare System in Boston.

“Fall risk assessment and health information technology have been underused in fall prevention efforts,” the researchers wrote. “Fall risk assessment provides a baseline measure of risk status to guide interventions to counteract identified risks. Currently, insufficient evidence exists to link specific fall prevention protocols with decreased fall rates in short-stay hospitals.”

The researchers developed a fall prevention tool kit with a fall risk assessment scale using health information technology. After the assessment was completed by a nurse, the tool kit software developed fall prevention intervention materials, including posters, patient education handouts and plans of care.

The study took place in four urban hospitals from Jan. 1, 2009, to June 30, 2009, and the fall rates in usual units (control) and intervention units were compared. The primary outcome was the number of patient falls per 1,000 patient-days. Fall-related injuries were a secondary outcome.

In the control units, there were 87 falls, and in the intervention units, there were 67 falls. The fall rate for the control unit was 4.18 per 1,000 patient-days, which was significantly higher than the 3.15 per 1,000 patient-days fall rate in the intervention unit. They also found that the patients aged 65 and older benefited most from the intervention. There was no significant effect on fall-related injuries.

“A health information technology intervention targeting underlying areas of risk can prevent patient falls in older patients in acute care hospitals,” the researchers concluded. “Further study is needed to determine if a similar program evaluated over a longer period of time can significantly reduce repeat falls.”

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