Are there randomized controlled trials of multi-pronged interventions to reduce falls in acute care settings?

There are two randomized controlled trials on multiple interventions to prevent falls in acute care settings.

Dykes PC, et al.  Fall prevention in acute care hospitals : A randomized trial.  JAMA. 2010;304(17):1912-1918.
This study randomly assigned nursing units 1) to use an intervention including a specific risk assessment tool, care plan based on the assessment, patient and family education materials or 2) to provide usual care (control). Baseline characteristics of units were similar. Table 3 (p. 1916) summarizes differences in fall rates (per 1,000 patient days) for all patients as well as specifically for patients aged 65+. Significant differences favored the units using the intervention.

Ang E, Mordiffi SZ, Wong HB. Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial. J Adv Nurs. 2011;67(9):1984-1992.
There were 912 and 910 participants in the control and intervention groups, respectively. Intervention group patients received usual care and targeted multiple interventions based on individual risk factors of the Hendrich II Falls Risk Model; unfortunately, the article does not provide examples of interventional techniques. The fall incidence rates were 1·5% (95% CI: 0·9-2·6) and 0·4% (95% CI: 0·2-1·1) in the control and intervention groups, respectively. The relative risk estimate of 0·29 (95% CI: 0·1-0·87) favors the intervention group.

Reviewed and updated 4/10/2014 ldt

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