Design, setting and participants: Three-year quality improvement project comparing data at baseline (2001) and at 2-year follow-up (2003) after interventions to reduce falls. All patients admitted to the Aged Care Services wards at Caulfield General Medical Centre, Melbourne, between January 2001 and December 2003 were included.
Interventions: Multistrategy approach phased in over 3 months from September 2001 and involving data gathering, risk screening with appropriate interventions, work practice changes, environmental and equipment changes, and staff education.
Results: Over a 2-year period, there was a 19% reduction in the number of falls per 1000 occupied bed-days (OBDs) (12.5 v 10.1; P = 0.001) and a 77% reduction in the number of falls resulting in serious injuries per 1000 OBDs (0.73 v 0.17; P < 0.001). Staff compliance with completing the falls risk assessment tool increased from 42% to 70%, and 60% of staff indicated they had changed their work practices to prevent falls.
Conclusion: A multistrategy falls prevention program in an aged care hospital setting produced a significant reduction in the number of falls and a marked reduction in serious fall-related injuries. Incorporating a falls prevention program into all levels of an organisation, as part of daily care, is crucial to the success and sustainability of falls prevention.
- 1. Joanna Briggs Institute. Falls in hospitals. Best Practice 1998; 2 (2).
- 2. Mathers C, Penm R. Health system costs of injury, poisoning and musculoskeletal disorders in Australia 1993–94. Canberra: Australian Institute of Health and Welfare, 1999. (AIHW Cat. No. HWE 12; Health and Welfare Expenditure Series No. 6.)
- 3. Gillespie LD, Gillespie WJ, Robertson MC, et al. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 2003; (4): CD000340.
- 4. American Geriatrics Society, British Geriatrics Society and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664-672.
- 5. Chang J, Morton S, Rubenstein L, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ 2004; 328: 680-683.
- 6. Oliver D, Hopper A, Seed P. Do hospital fall prevention programs work? A systematic review. J Am Geriatr Soc 2000; 48: 1679-1689.
- 7. Hayes N. Prevention of falls among older patients in the hospital environment. Br J Nurs 2004; 13: 896-901.
- 8. National Ageing Research Institute. An analysis of research on preventing falls injury in older people: acute care settings. Report to the Commonwealth Department of Health and Aged Care Injury Prevention Section. Melbourne: NARI, 2000.
- 9. Evans D, Hodgkinson B, Lambert L, et al. Falls in acute hospitals — a systematic review. Adelaide: Joanna Briggs Institute, 1998.
- 10. Guelich M. Prevention of falls in the elderly: a literature review. Top Geriatr Rehabil 1999; 15: 15-25.
- 11. Barrett J, Bradshaw M, Hutchinson K, et al. Reduction of falls-related injuries using a hospital inpatient falls prevention program. J Am Geriatr Soc 2004; 52: 1969-1970.
- 12. Haines T, Bennell K, Osborne R, Hill K. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. BMJ 2004, 328: 676-679.
- 13. Healey F, Monro A, Cockram A, et al. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age Ageing 2004; 33: 390-395.
- 14. MacAvoy S, Skinner T, Hines M. Clinical methods. Fall risk assessment tool. Appl Nurs Res 1996; 9: 213-218.
- 15. Vassallo M, Vignaraja R, Sharma J, et al. The effect of changing practice on fall prevention in a rehabilitative hospital: the Hospital Injury Prevention Study. J Am Geriatr Soc 2004; 52: 335-339.
- 16. Oliver D. Prevention of falls in hospital inpatients. Agendas for research and practice [editorial]. Age Ageing 2004; 33: 328-330.
- 17. Mitchell A, Jones N. Striving to prevent falls in an acute care setting — action to enhance quality. J Clin Nurs 1996; 5: 213-220.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.