Evaluation of a falls prevention programme in an acute tertiary care hospital
Article first published online: 11 JAN 2007
Journal of Clinical Nursing
Volume 16, Issue 2, pages 316–324, February 2007
How to Cite
Williams, T. A., King, G., Hill, A.-M., Rajagopal, M., Barnes, T., Basu, A., Pascoe, G., Birkett, K. and Kidd, H. (2007), Evaluation of a falls prevention programme in an acute tertiary care hospital. Journal of Clinical Nursing, 16: 316–324. doi: 10.1111/j.1365-2702.2005.01410.x
- Issue published online: 11 JAN 2007
- Article first published online: 11 JAN 2007
- Submitted for publication: 9 December 2004 Accepted for publication: 20 April 2005
- acute care hospital;
- adult falls;
- older people;
Aims and objectives. To evaluate a systematic, coordinated approach to limit the severity and minimize the number of falls in an acute care hospital.
Background. Patient falls are a significant cause of preventable injury and death, particularly in older patients. Best practice principles mandate that hospitals identify those patients at risk of falling and implement interventions to prevent or minimize them.
Methods. A before and after design was used for the study. All patients admitted to three medical wards and a geriatric evaluation management unit were enrolled over a six-month period. Patients’ risk of falling was assessed using a falls risk assessment tool and appropriate interventions implemented using a falls care plan. Data related to the number and severity of falls were obtained from the Australian Incident Monitoring System database used at the study site.
Results. In this study, 1357 patient admissions were included. According to their risk category, 37% of patients (n = 496) were grouped as low risk (score = 1–10), 58% (n = 774) medium risk (score = 11–20) and 5% (n = 63) high risk (score = 21–33) for falls. The incidence of falls (per average occupied bed day) was eight per 1000 bed days for the study period. Compared with the same months in 2002/2003, there was a significant reduction in falls from 0·95 to 0·80 (95% CI for the difference −0·14 to −0·16, P < 0·001).
Conclusion. We evaluated a systematic, coordinated approach to falls management that included a falls risk assessment tool and falls care plan in the acute care setting. Although a significant reduction in falls was found in this study, it could not be attributed to any specific interventions.
Relevance to clinical practice. Preventing falls where possible is essential. Assessment of risk and use of appropriate interventions can reduce the incidence of falls.