A multifactorial intervention did not prevent falls or fractures in elderly patients during short hospital stays

摘要

QUESTIONDoes a tailored, multifactorial intervention prevent falls in elderly patients during short hospital stays?METHODSDesign: cluster randomised controlled trial.Allocation: unclear allocation concealment.Blinding: unblinded.Follow-up period: during stay in study ward.Setting: 24 elderly care wards in 12 hospitals in Sydney, NewSouth Wales, Australia.Patients: 3999 patients (mean age 79 y; 59% women; meanlengths of stay, acute wards 8.2 to 8.5 d, rehabilitation wards16.5 to 16.8 d).Intervention: 2047 patients in 12 wards received amultifactorial intervention delivered by a nurse and aphysiotherapist. The intervention included a falls riskassessment, usually within 24 hours of admission; patient,family, and staff education from the nurse andphysiotherapist; appropriate patient support (walking aids,eyewear, bedside modifications, and increased supervision);staff liaison for management of confusion, drug changes, andfoot problems; and physiotherapist support for referredpatients, including exercises for balance and functionalabilities, and practice of safe mobility. Selected patients whorequired support for walking wore a pressure alarm on one foot. 1952 patients in 12 wards received usual care.Outcome: number of falls in study wards (a fall was defined as unintentionally coming to rest on the ground or other lower level, except as a result of major internal or external events).