Patient education to prevent falls among older hospital inpatients
Haines, T. P., Hill, A., Hill, K. D., McPhail, S., Oliver, D., Brauer, S., Hoffmann, T., & Beer, C. (2011). Patient education to prevent falls among older hospital inpatients. Archives of Internal Medicine, 171 (6), 516-524.
Background: Falls are a common adverse event during hospitalizationof older adults, and few interventions have been shown to prevent hem.
Methods: This study was a 3-group randomized trial to evaluatethe efficacy of 2 forms of multimedia patient education comparedwith usual care for the prevention of in-hospital falls. Olderhospital patients (n = 1206) admitted to a mixtureof acute (orthopedic, respiratory, and medical) and subacute(geriatric and neurorehabilitation) hospital wards at 2 Australianhospitals were recruited between January 2008 and April 2009.The interventions were a multimedia patient education programbased on the health-belief model combined with trained healthprofessional follow-up (complete program), multi-media patienteducation materials alone (materials only), and usual care (control).Falls data were collected by blinded research assistants byreviewing hospital incident reports, hand searching medicalrecords, and conducting weekly patient interviews.
Results: Rates of falls per 1000 patient-days did not differsignificantly between groups (control, 9.27; materials only,8.61; and complete program, 7.63). However, there was a significantinteraction between the intervention and presence of cognitiveimpairment. Falls were less frequent among cognitively intactpatients in the complete program group (4.01 per 1000 patient-days)than among cognitively intact patients in the materials-onlygroup (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51;95% confidence interval, 0.28-0.93]) and control group (8.72per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidenceinterval, 0.24-0.78).
Conclusion: Multimedia patient education with trained healthprofessional follow-up reduced falls among patients with intactcognitive function admitted to a range of hospital wards.