Use of a project nurse to encourage evidence-based falls injury prevention strategies did not reduce falls or fall injuries over 17 months in residential aged care facilities in Australia.

摘要

Falls and fracture are a major public and personal health issue for older people especially in residential care. It has proved difficult to prevent falls and fracture in residential care, perhaps because the population is very frail, the staff reportedly overstressed and the resources for pragmatic change scarce.This is a randomised trial testing best practice falls prevention in a large number of residential care facilities in Australia. The intervention was one specialist nurse delivering the 'Green Box' guidelines for falls prevention to 46 residential facilities with 2802 persons. There were training sessions for the 'link' nurses in groups and exercise therapists, and ongoing 'network meetings' three monthly. There were 215 hip fractures and 33% Of residents with hip fracture died within 3 months! Vitamin D use increased in all facilities, hip protector use was low and stayed low. There was no difference in the number of falls, hip fractures, hospitalisations after a fall or any measured outcome between the intervention and control group facilities. This was a very pragmatic attempt at preventing falls, a nurse in charge of several facilities (46) using evidence-based resources and standard training/ implementation type strategies.