Patricia C. Dykes|Diane L. Carroll|Ann C. Hurley|Stuart R. Lipsitz|Angela Benoit|Frank Chang|Seth N. Meltzer|Ruslana Tsurikova|Lyubov Zuyov|Blackford Middleton
Fall Prevention in Acute Care Hospitals
falls cause injury death persons ages risk falls increases markedly age hospitalization increases risk yet evidence exists support shortstay hospitalbased fall prevention strategies reduce patient fallsto investigate whether fall prevention tool kit fptk using health information technology hit decreases patient falls hospitalscluster randomized study conducted january 1 2009 june 30 2009 comparing patient fall rates 4 urban us hospitals units received usual care 4 units 5104 patients intervention 4 units 5160 patientsthe fptk integrated existing communication workflow patterns hit application based valid fall risk assessment scale completed nurse fptk software tailored fall prevention interventions address patients specific determinants fall risk fptk produced bed posters composed brief text accompanying icon patient education handouts plans care communicating patientspecific alerts key stakeholdersthe primary outcome patient falls per 1000 patientdays adjusted site patient care unit secondary outcome fallrelated injuriesduring 6month intervention period number patients falls differed control n 87 intervention n 67 units p02 siteadjusted fall rates significantly higher control units 418 95 confidence interval ci 345506 per 1000 patientdays intervention units 315 95 ci 254390 per 1000 patientdays p 04 fptk found particularly effective patients aged 65 years older adjusted rate difference 208 95 ci 061356 per 1000 patientdays p 003 significant effect noted fallrelated injuriesthe use fall prevention tool kit hospital units compared usual care significantly reduced rate fallsclinicaltrialsgov identifier nct00675935