Friday 20th May 2016, Wesley Conference Centre, Sydney
Author Archives: Lillian Bull
Research Paper Highlight
Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
Hill AM, McPhail SM, Waldron N, et al. The Lancet. 2015 Apr 9. doi:10.1016/S0140-6736(14)61945-0.
Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme.
Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients’ goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886).
Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]).
Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units.
State Health Research Advisory Council, Department of Health, Government of Western Australia.
Watch Your Step: 2016 National Fall Prevention Conference – Applying Integrated Approaches
May 16 and 17 at The Coast Plaza Hotel & Conference Centre in Calgary, Alberta!
This leading fall prevention conference is presented in partnership with the Injury Prevention Centre, University of Alberta and Alberta Health Services.
Note! We are currently accepting sponsor and exhibitor partnerships. At this conference, we will present a lively and informative Fall Prevention Marketplace and we strongly urge exhibitors who are interested in participating in this opportunity to book your space immediately. Exhibitor spots sold out in 2014!
For more information, please contact Karin Ivand, Conference Manager, at 647-343-5034 or firstname.lastname@example.org
Delegate registration will be open soon!