Patient education to prevent falls among older hospital inpatients
Haines, T. P.,
Hill, K. D.,
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.