Prevention kit may lower fall rates in hospitals

Use of a fall prevention tool kit — which includes a fall risk assessment, patient-specific prevention plan, educational handout and poster to hang over the patient’s bed — reduced the number of falls among older hospital patients, according to a study in the Journal of the American Medical Association.

Patricia C. Dykes, RN, DNSc, an author of the study, reported the findings at a Journal of the American Medical Association (JAMA) media briefing. According to background information in the study, no previous evidence supports short-stay hospital-based fall prevention strategies to reduce patient falls.

A 6-month study

Dykes and her team conducted the study from January to June of 2009 and compared the patient fall rates of four urban hospitals in the United States that received usual care (four units and 5,104 patients) or the intervention (four units and 5,160 patients). A slight majority — 51.3% — of patients were 65 years of age or older, and the average age among this population was 79 years. A subpopulation of patients younger than 65 years had an average age of 48 years.

The fall prevention tool kit used in the study contained a fall risk assessment scale completed by a nurse to tailor fall prevention interventions that addressed patients’ specific determinants of fall risk. The kit also included patient education handouts, plans of care and posters composed of brief text with accompanying icons — all communicating patient-specific alerts to those involved with care.

Effectiveness of the kit

The researchers found that after the intervention period, fewer patients had falls in the intervention units compared to the control units (67 vs. 87). Further analysis revealed that the intervention units had a significantly lower adjusted fall rate than control units.

The intervention was noted to be “significantly better” for older patients, but the authors added that it had no effect in the younger patient population. Furthermore, there was no significant effect noted in fall-related injuries. Still, the authors calculated that for the eight units involved in the study, the kit could potentially prevent one fall every 4 days, 7.5 falls each month and around 90 falls per year.

“The effectiveness of the [fall prevention tool kit] in older patients provides evidence that a [health information technology] program that tailors interventions to address patient-specific determinants of risk and is implemented within existing workflows is effective in acute care hospitals with older adults,” the authors wrote. “Because patient falls in hospitals are a major risk factor for fractures and other injuries, reducing falls is an important first step toward injury prevention, and any reduction in patient falls has clinical significance.

Reference:
Dykes PC, Carroll DL, Hurley A, et al. Fall prevention in acute care hospitals: A randomized trial. JAMA. 2010;304(17):1912-1918.

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