ABSTRACT
OBJECTIVE: To evaluate the effectiveness of an intervention programme to reduce falls among geriatric rehabilitation patients. DESIGN: Pre/post-test design with independent pre-test and matched post-test samples. SETTING: Inpatient geriatric wards in a rehabilitation hospital. PARTICIPANTS: Seventy-six matched pairs (n = 152) of geriatric rehabilitation patients from one control and one intervention ward participated in the study, and 36 nursing staff surveys were completed. INTERVENTION: The intervention programme was developed based on interviews and systematic reviews. Educational materials were distributed to patients and families, and preventive measures were implemented. MAIN OUTCOME MEASURES: The rates of falls before and after the intervention both within and between the wards were compared, and surveys were completed. RESULTS: The matched patients presented no significant differences on age, gender or medical conditions. The falls rates, proportion of fallers and length of stay was higher among those in the control ward (P< 0.043). The percentage of fallers and the rate of falls/1000 patient days were lower on the intervention ward after implementation: odds ratio (95% confidence interval) = -2.9 (-6.6, -1.2) and -1.8 (-6.0, 0.5). Thirty of 36 respondents considered the tool to be helpful and beneficial for use on other wards. CONCLUSION: The intervention programme was effective in reducing falls among geriatric rehabilitation patients.
Subject(s)
Accidental Falls/prevention & control , Health Personnel/education , Patients' Rooms/organization & administration , Rehabilitation Centers/organization & administration , Accidental Falls/statistics & numerical data , Aged , Aged, 80 and over , Comorbidity , Female , Humans , Inpatients , Inservice Training/methods , Length of Stay/statistics & numerical data , Lighting/instrumentation , Lighting/standards , Male , Mandatory Reporting , Patient Education as Topic/methods , Patients' Rooms/standards , Quality Improvement/organization & administration , Quality Improvement/standards , Risk Assessment , Self-Help Devices , WorkforceABSTRACT
OBJECTIVE: The objective of this study was to establish the rates and to gather information from patients, staff and family members on risks and potential measures to prevent patient falls on geriatric rehabilitation units in a hospital. METHODS: The falls recorded in the geriatric rehabilitation units between January 2006 and December 2008 were reviewed to establish their rates (falls/1000 patient days) and locations. Twenty-eight interviews with ten patients, twelve staff and six family members were conducted in one of the units. The identified risks and suggestions were organised using the International Classification of Functioning, Disability and Health (ICF) areas--body function and structure, activity and participation, personal and environmental factors. RESULTS: The rates of falls (mean ± SD) on the two units evaluated were 7 ± 4 and 8 ± 4. The several risks and potential interventions to prevent falls that emerged from the 28 interviews were presented on figures and tables including examples of the participant quotes. CONCLUSIONS: The findings highlight the complexity of the problem and the value of the approach used to increase our understanding of the issues considering the perspectives of patients, staff and family members. The results are being used to construct context-specific interventions to reduce the rates of falls.
