Get access

Fall Prevention in Residential Care: A Cluster, Randomized, Controlled Trial

Authors

  • Ngaire Kerse MBChB, PhD,

    1. From the Departments of *General Practice and Primary Health CareCommunity Health, University of Auckland, Auckland, New ZealandHarkness Fellow in Health Care Policy, Center For Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington§Health Services for Older People, Waitemata District Health Board, Auckland, New Zealand.
    Search for more papers by this author
  • Meg Butler MPH,

    1. From the Departments of *General Practice and Primary Health CareCommunity Health, University of Auckland, Auckland, New ZealandHarkness Fellow in Health Care Policy, Center For Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington§Health Services for Older People, Waitemata District Health Board, Auckland, New Zealand.
    Search for more papers by this author
  • Elizabeth Robinson MSc,

    1. From the Departments of *General Practice and Primary Health CareCommunity Health, University of Auckland, Auckland, New ZealandHarkness Fellow in Health Care Policy, Center For Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington§Health Services for Older People, Waitemata District Health Board, Auckland, New Zealand.
    Search for more papers by this author
  • Maree Todd FRACP, MBChB

    1. From the Departments of *General Practice and Primary Health CareCommunity Health, University of Auckland, Auckland, New ZealandHarkness Fellow in Health Care Policy, Center For Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington§Health Services for Older People, Waitemata District Health Board, Auckland, New Zealand.
    Search for more papers by this author

  • This work was supported by project grants from the Health Research Council of New Zealand, the Auckland Medical Research Foundation, and the Royal New Zealand College of General Practitioners' Auckland Faculty Trust, and by a Harkness Fellowship from the Commonwealth Fund.

  • Presented at the International Gerontological Association scientific meeting, Vancouver, 2001, and the New Zealand Gerontological Association, Auckland, 2002.

Address correspondence to Dr. Ngaire Kerse, Associate Professor, Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail: n.kerse@auckland.ac.nz

Abstract

Objectives: To establish the effectiveness of a fall-prevention program in reducing falls and injurious falls in older residential care residents.

Design: Cluster, randomized, controlled trial.

Setting: Fourteen randomly selected residential care homes in Auckland, New Zealand.

Participants: All older residents (n=628, 95% participation rate).

Intervention: Residential care staff, using existing resources, implemented systematic individualized fall-risk management for all residents using a fall-risk assessment tool, high-risk logo, and strategies to address identified risks.

Measurements: Number of residents sustaining a fall, falls, and injurious-falls incidence rates.

Results: During 12 months of follow-up, 103 (43%) residents in the control group and 173 (56%) residents in the intervention group fell (P<.018). There was a significantly higher incidence rate of falls in intervention homes than in control homes (incident rate ratio=1.34, 95% confidence interval=1.06–1.72) during the intervention period after adjusting for dependency level (type of home), baseline fall rate, and clustering. There was no difference in the injurious fall incidence rate or incidence of serious injuries.

Conclusion: This fall-prevention intervention did not reduce falls or injury from falls. Low-intensity intervention may be worse than usual care.

Get access to the full text of this article

Ancillary