Interventions to reduce the incidence of falls in older adult patients in acute-care hospitals: a systematic review

Authors

  • Cindy Stern BHS(Hons),

    Corresponding author
    1. The National Evidence Based Aged Care Unit (NEBACU) of the Joanna Briggs Institute,
    2. School of Population Health and Clinical Practice, The University of Adelaide, and
      Ms Cindy Stern, The Joanna Briggs Institute, C/- Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. Email: cindy.stern@adelaide.edu.au
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  • Rasika Jayasekara RN BA BScN(Hons) PGDipEdu MNSc PhD

    1. School of Population Health and Clinical Practice, The University of Adelaide, and
    2. The Joanna Briggs Institute, Adelaide, South Australia, Australia
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Ms Cindy Stern, The Joanna Briggs Institute, C/- Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. Email: cindy.stern@adelaide.edu.au

Abstract

Aim  Falls can cause serious physical and emotional injuries to patients leading to poor quality of life and increased length of hospital stay. The aim of this study was to present the best available evidence regarding the effectiveness of risk assessment or other interventions that aimed to minimise the number of falls.

Methods  A systematic review of randomised controlled trials was undertaken to determine the effectiveness of interventions that were designed to reduce the incidence of falls in older acute-care patients. Only trials published between 1998 and 2008 were considered.

Results  Only seven studies were included in the review, indicating the evidence on this topic is sparse. There is some evidence to suggest that implementing the following interventions in acute hospitals may be effective in reducing the amount of falls of older adult inpatients:

  • • A multidisciplinary multifactorial intervention program consisting of falls risk alert card, an exercise program, an education program and the use of hip protectors after approximately 45 days
  • • A one-on-one patient education package entailing information on risk factors and preventative strategies for falls as well as goal setting
  • • A targeted fall risk factor reduction intervention that includes a fall risk factor screen, recommended interventions encompassing local advice and a summary of the evidence

There is also some evidence to suggest that implementing a multidisciplinary multifactorial intervention that consists of systematic assessment and treatment of fall risk factors, as well as active management of postoperative complications, can reduce the amount of falls in patients following surgery for femoral neck fracture.

Conclusion  There is some evidence to suggest that certain multifactorial interventions are more effective than others and that increasing patient education or targeting fall risk factors may be of benefit. Further high-quality research is needed in order to ascertain effective fall-prevention strategies in acute-care facilities.

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