Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial

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Abstract
Objective To assess the effectiveness of a targeted, multiple intervention falls prevention programme in reducing falls and injuries related to falls in a subacute hospital. Design Randomised controlled trial of a targeted multiple intervention programme implemented in addition to usual care compared with usual care alone. Setting Three subacute wards in a metropolitan hospital specialising in rehabilitation and care of elderly patients. Participants 626 men and women aged 38 to 99 years (average 80 years) were recruited from consecutive admissions to subacute hospital wards. Intervention Falls risk alert card with information brochure, exercise programme, education programme, and hip protectors. Main outcome measures Incidence rate of falls, injuries related to falls, and proportion of participants who experienced one or more falls during their stay in hospital. Results Participants in the intervention group (n = 310) experienced 30% fewer falls than participants in the control group (n = 316). This difference was significant (Peto log rank test P = 0.045) and was most obvious after 45 days of observation. In the intervention group there was a trend for a reduction in the proportion of participants who experienced falls (relative risk 0.78, 95% confidence interval 0.56 to 1.06) and 28% fewer falls resulted in injury (log rank test P = 0.20). Conclusions A targeted multiple intervention falls prevention programme reduces the incidence of falls in the subacute hospital setting.