schliessen

Filtern

 

Bibliotheken

Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial

Summary Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Methods Eight rehabilitation units... Full description

Journal Title: The Lancet (British edition) 2015, Vol.385 (9987), p.2592-2599
Main Author: Hill, Anne-Marie, Dr
Other Authors: McPhail, Steven M, PhD , Waldron, Nicholas, MD , Etherton-Beer, Christopher, Prof , Ingram, Katharine, MBBS , Flicker, Leon, Prof , Bulsara, Max, Prof , Haines, Terry P, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/25865864
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_1692754587
title: Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
format: Article
creator:
  • Hill, Anne-Marie, Dr
  • McPhail, Steven M, PhD
  • Waldron, Nicholas, MD
  • Etherton-Beer, Christopher, Prof
  • Ingram, Katharine, MBBS
  • Flicker, Leon, Prof
  • Bulsara, Max, Prof
  • Haines, Terry P, Prof
subjects:
  • Abridged Index Medicus
  • Accidental Falls - mortality
  • Accidental Falls - prevention & control
  • Accidental Falls - statistics & numerical data
  • Aged, 80 and over
  • Analysis
  • Australia
  • Australia - epidemiology
  • Cluster Analysis
  • Cognition - classification
  • Comorbidity
  • Education
  • Education, Continuing - organization & administration
  • Education, Continuing - statistics & numerical data
  • Falls
  • Female
  • Health Education - organization & administration
  • Health Education - statistics & numerical data
  • Heart Diseases - epidemiology
  • Hip Fractures - epidemiology
  • Hospital Units - statistics & numerical data
  • Hospitals
  • Humans
  • Incidence
  • Internal Medicine
  • Intervention
  • Length of Stay - statistics & numerical data
  • Male
  • Medical research
  • Musculoskeletal Diseases - epidemiology
  • Nervous System Diseases - epidemiology
  • Patient education
  • Patient Education as Topic - organization & administration
  • Patient Education as Topic - statistics & numerical data
  • Patient Outcome Assessment
  • Patient Readmission - statistics & numerical data
  • Pragmatism
  • Program Evaluation
  • Rehabilitation
  • Rehabilitation - education
  • Rehabilitation Centers - statistics & numerical data
  • Respiratory Tract Diseases - epidemiology
  • Statistics
  • Stroke - epidemiology
  • Studies
  • Survival Rate
  • Treatment Outcome
ispartof: The Lancet (British edition), 2015, Vol.385 (9987), p.2592-2599
description: Summary Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Methods Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Findings Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). Interpretation Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. Funding State Health Research Advisory Council, Department of Health, Government of Western Australia.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.713129
LOCALfalse
PrimoNMBib
record
control
sourceidgale_proqu
recordidTN_cdi_proquest_miscellaneous_1692754587
sourceformatXML
sourcesystemPC
galeidA518061155
sourcerecordidA518061155
originalsourceidFETCH-LOGICAL-1789t-bd0a6826119b6273c85418e527bfa2c88ce065fd26dbb4a15cc67bf407642edf3
addsrcrecordideNqNku9r1DAYx4so7pz-CUrBNxOuM-klaW-CMoZTYeALFXwX0uRpLzP9YZJO9h_5Z_rcdW7nIdxoadLk8_32eZpvkjyn5JgSKl5_IZSRTBQLcUTZK0GXjGfkQTKjrGAZZ8X3h8nsFjlInoRwSQhhgvDHyUHOS4E3myW_z5VzqVcRQmq7dNWHwUaFK7BSlXU4j7bv0rGzMaSqjuARM_bKmlE5G8CkAxLQxVR1Jg1R1XUKZtSTbPB941XbQjhJFb6ppsUNPUcQhgFM9gtMA_NUuxFXfObRpG83trrvou-dw2n0VrmnyaNauQDPbsbD5Nv5-69nH7OLzx8-nZ1eZLQolzGrDFGizAWly0rkxUKXnNESeF5Utcp1WWoggtcmF6aqmKJca4FbjBSC5WDqxWFyNPli7T9HCFFiPRqcUx30Y5C0oEQItqTFflQs84IzXq7RlzvoZT_6DhtZU3RB8UxLpI4nqlEOpO3qPnql8TLQWvwhUFtcP-W0JNgg5_cVsJyWFEumKHjxH4HcdpxvAdUYbAcBH8E2qxgaNYbwbwH3wLc_zydc-z4ED7UcvG2Vv5aUyHWs5SbWcp1ZSZncxFqSu7KHsWrB3Kr-5hiBNzvG-ia62J91e-3fTWrAYF1Z8DJozLQGYz3oKE1v9zq83XHQznZWK_cDriHcHbYMuSSTydqDso0DWfwBV5cumg
sourcetypeAggregation Database
isCDItrue
recordtypearticle
pqid1691311018
display
typearticle
titleFall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
sourceAlma/SFX Local Collection
creatorHill, Anne-Marie, Dr ; McPhail, Steven M, PhD ; Waldron, Nicholas, MD ; Etherton-Beer, Christopher, Prof ; Ingram, Katharine, MBBS ; Flicker, Leon, Prof ; Bulsara, Max, Prof ; Haines, Terry P, Prof
creatorcontribHill, Anne-Marie, Dr ; McPhail, Steven M, PhD ; Waldron, Nicholas, MD ; Etherton-Beer, Christopher, Prof ; Ingram, Katharine, MBBS ; Flicker, Leon, Prof ; Bulsara, Max, Prof ; Haines, Terry P, Prof
descriptionSummary Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Methods Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Findings Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). Interpretation Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. Funding State Health Research Advisory Council, Department of Health, Government of Western Australia.
identifier
0ISSN: 0140-6736
1EISSN: 1474-547X
2DOI: 10.1016/S0140-6736(14)61945-0
3PMID: 25865864
4CODEN: LANCAO
languageeng
publisherEngland: Elsevier Ltd
subject
ispartofThe Lancet (British edition), 2015, Vol.385 (9987), p.2592-2599
rights
0Elsevier Ltd
12015 Elsevier Ltd
2Copyright © 2015 Elsevier Ltd. All rights reserved.
3COPYRIGHT 2015 Elsevier B.V.
4Copyright Elsevier Limited Jun 27, 2015
lds50peer_reviewed
oafree_for_read
citedbyFETCH-LOGICAL-1789t-bd0a6826119b6273c85418e527bfa2c88ce065fd26dbb4a15cc67bf407642edf3
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
thumbnail$$Usyndetics_thumb_exl
backlink$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25865864$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Hill, Anne-Marie, Dr
1McPhail, Steven M, PhD
2Waldron, Nicholas, MD
3Etherton-Beer, Christopher, Prof
4Ingram, Katharine, MBBS
5Flicker, Leon, Prof
6Bulsara, Max, Prof
7Haines, Terry P, Prof
title
0Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
1The Lancet (British edition)
addtitleLancet
descriptionSummary Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Methods Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Findings Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). Interpretation Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. Funding State Health Research Advisory Council, Department of Health, Government of Western Australia.
subject
0Abridged Index Medicus
1Accidental Falls - mortality
2Accidental Falls - prevention & control
3Accidental Falls - statistics & numerical data
4Aged, 80 and over
5Analysis
6Australia
7Australia - epidemiology
8Cluster Analysis
9Cognition - classification
10Comorbidity
11Education
12Education, Continuing - organization & administration
13Education, Continuing - statistics & numerical data
14Falls
15Female
16Health Education - organization & administration
17Health Education - statistics & numerical data
18Heart Diseases - epidemiology
19Hip Fractures - epidemiology
20Hospital Units - statistics & numerical data
21Hospitals
22Humans
23Incidence
24Internal Medicine
25Intervention
26Length of Stay - statistics & numerical data
27Male
28Medical research
29Musculoskeletal Diseases - epidemiology
30Nervous System Diseases - epidemiology
31Patient education
32Patient Education as Topic - organization & administration
33Patient Education as Topic - statistics & numerical data
34Patient Outcome Assessment
35Patient Readmission - statistics & numerical data
36Pragmatism
37Program Evaluation
38Rehabilitation
39Rehabilitation - education
40Rehabilitation Centers - statistics & numerical data
41Respiratory Tract Diseases - epidemiology
42Statistics
43Stroke - epidemiology
44Studies
45Survival Rate
46Treatment Outcome
issn
00140-6736
11474-547X
fulltexttrue
rsrctypearticle
creationdate2015
recordtypearticle
recordideNqNku9r1DAYx4so7pz-CUrBNxOuM-klaW-CMoZTYeALFXwX0uRpLzP9YZJO9h_5Z_rcdW7nIdxoadLk8_32eZpvkjyn5JgSKl5_IZSRTBQLcUTZK0GXjGfkQTKjrGAZZ8X3h8nsFjlInoRwSQhhgvDHyUHOS4E3myW_z5VzqVcRQmq7dNWHwUaFK7BSlXU4j7bv0rGzMaSqjuARM_bKmlE5G8CkAxLQxVR1Jg1R1XUKZtSTbPB941XbQjhJFb6ppsUNPUcQhgFM9gtMA_NUuxFXfObRpG83trrvou-dw2n0VrmnyaNauQDPbsbD5Nv5-69nH7OLzx8-nZ1eZLQolzGrDFGizAWly0rkxUKXnNESeF5Utcp1WWoggtcmF6aqmKJca4FbjBSC5WDqxWFyNPli7T9HCFFiPRqcUx30Y5C0oEQItqTFflQs84IzXq7RlzvoZT_6DhtZU3RB8UxLpI4nqlEOpO3qPnql8TLQWvwhUFtcP-W0JNgg5_cVsJyWFEumKHjxH4HcdpxvAdUYbAcBH8E2qxgaNYbwbwH3wLc_zydc-z4ED7UcvG2Vv5aUyHWs5SbWcp1ZSZncxFqSu7KHsWrB3Kr-5hiBNzvG-ia62J91e-3fTWrAYF1Z8DJozLQGYz3oKE1v9zq83XHQznZWK_cDriHcHbYMuSSTydqDso0DWfwBV5cumg
startdate2015
enddate2015
creator
0Hill, Anne-Marie, Dr
1McPhail, Steven M, PhD
2Waldron, Nicholas, MD
3Etherton-Beer, Christopher, Prof
4Ingram, Katharine, MBBS
5Flicker, Leon, Prof
6Bulsara, Max, Prof
7Haines, Terry P, Prof
general
0Elsevier Ltd
1Elsevier B.V
2Elsevier Limited
scope
0CGR
1CUY
2CVF
3ECM
4EIF
5NPM
6AAYXX
7CITATION
8BKMMT
9BSHEE
100TT
110TZ
120U~
133V.
147QL
157QP
167RV
177TK
187U7
197U9
207X7
217XB
2288A
2388C
2488E
2588G
2688I
278AF
288AO
298C1
308C2
318FE
328FH
338FI
348FJ
358FK
368G5
37ABUWG
38AN0
39ASE
40AZQEC
41BBNVY
42BEC
43BENPR
44BHPHI
45C1K
46DWQXO
47FPQ
48FYUFA
49GHDGH
50GNUQQ
51GUQSH
52H94
53HCIFZ
54K6X
55K9-
56K9.
57KB0
58KB~
59LK8
60M0R
61M0S
62M0T
63M1P
64M2M
65M2O
66M2P
67M7N
68M7P
69MBDVC
70NAPCQ
71PQEST
72PQQKQ
73PQUKI
74Q9U
75S0X
767X8
sort
creationdate2015
titleFall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
authorHill, Anne-Marie, Dr ; McPhail, Steven M, PhD ; Waldron, Nicholas, MD ; Etherton-Beer, Christopher, Prof ; Ingram, Katharine, MBBS ; Flicker, Leon, Prof ; Bulsara, Max, Prof ; Haines, Terry P, Prof
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-1789t-bd0a6826119b6273c85418e527bfa2c88ce065fd26dbb4a15cc67bf407642edf3
rsrctypearticles
prefilterarticles
languageeng
creationdate2015
topic
0Abridged Index Medicus
1Accidental Falls - mortality
2Accidental Falls - prevention & control
3Accidental Falls - statistics & numerical data
4Aged, 80 and over
5Analysis
6Australia
7Australia - epidemiology
8Cluster Analysis
9Cognition - classification
10Comorbidity
11Education
12Education, Continuing - organization & administration
13Education, Continuing - statistics & numerical data
14Falls
15Female
16Health Education - organization & administration
17Health Education - statistics & numerical data
18Heart Diseases - epidemiology
19Hip Fractures - epidemiology
20Hospital Units - statistics & numerical data
21Hospitals
22Humans
23Incidence
24Internal Medicine
25Intervention
26Length of Stay - statistics & numerical data
27Male
28Medical research
29Musculoskeletal Diseases - epidemiology
30Nervous System Diseases - epidemiology
31Patient education
32Patient Education as Topic - organization & administration
33Patient Education as Topic - statistics & numerical data
34Patient Outcome Assessment
35Patient Readmission - statistics & numerical data
36Pragmatism
37Program Evaluation
38Rehabilitation
39Rehabilitation - education
40Rehabilitation Centers - statistics & numerical data
41Respiratory Tract Diseases - epidemiology
42Statistics
43Stroke - epidemiology
44Studies
45Survival Rate
46Treatment Outcome
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Hill, Anne-Marie, Dr
1McPhail, Steven M, PhD
2Waldron, Nicholas, MD
3Etherton-Beer, Christopher, Prof
4Ingram, Katharine, MBBS
5Flicker, Leon, Prof
6Bulsara, Max, Prof
7Haines, Terry P, Prof
collection
0Medline
1MEDLINE
2MEDLINE (Ovid)
3MEDLINE
4MEDLINE
5PubMed
6CrossRef
7Gale General OneFile (A&I only)
8Academic OneFile (A&I only)
9News PRO
10Pharma and Biotech Premium PRO
11Global News & ABI/Inform Professional
12ProQuest Central (Corporate)
13Bacteriology Abstracts (Microbiology B)
14Calcium & Calcified Tissue Abstracts
15Nursing & Allied Health Database
16Neurosciences Abstracts
17Toxicology Abstracts
18Virology and AIDS Abstracts
19Health & Medical Collection
20ProQuest Central (purchase pre-March 2016)
21Biology Database (Alumni Edition)
22Healthcare Administration Database (Alumni)
23Medical Database (Alumni Edition)
24Psychology Database (Alumni)
25Science Database (Alumni Edition)
26STEM Database
27ProQuest Pharma Collection
28Public Health Database
29Lancet Titles
30ProQuest SciTech Collection
31ProQuest Natural Science Collection
32Hospital Premium Collection
33Hospital Premium Collection (Alumni Edition)
34ProQuest Central (Alumni) (purchase pre-March 2016)
35Research Library (Alumni Edition)
36ProQuest Central (Alumni Edition)
37British Nursing Database
38British Nursing Index
39ProQuest Central Essentials
40Biological Science Collection
41eLibrary
42ProQuest Central
43Natural Science Collection
44Environmental Sciences and Pollution Management
45ProQuest Central Korea
46British Nursing Index (BNI) (1985 to Present)
47Health Research Premium Collection
48Health Research Premium Collection (Alumni)
49ProQuest Central Student
50Research Library Prep
51AIDS and Cancer Research Abstracts
52SciTech Premium Collection
53British Nursing Index
54Consumer Health Database (Alumni Edition)
55ProQuest Health & Medical Complete (Alumni)
56Nursing & Allied Health Database (Alumni Edition)
57ProQuest Newsstand Professional
58ProQuest Biological Science Collection
59Consumer Health Database
60Health & Medical Collection (Alumni Edition)
61Healthcare Administration Database
62Medical Database
63Psychology Database
64Research Library
65Science Database
66Algology Mycology and Protozoology Abstracts (Microbiology C)
67Biological Science Database
68Research Library (Corporate)
69Nursing & Allied Health Premium
70ProQuest One Academic Eastern Edition
71ProQuest One Academic
72ProQuest One Academic UKI Edition
73ProQuest Central Basic
74SIRS Editorial
75MEDLINE - Academic
jtitleThe Lancet (British edition)
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Hill, Anne-Marie, Dr
1McPhail, Steven M, PhD
2Waldron, Nicholas, MD
3Etherton-Beer, Christopher, Prof
4Ingram, Katharine, MBBS
5Flicker, Leon, Prof
6Bulsara, Max, Prof
7Haines, Terry P, Prof
formatjournal
genrearticle
ristypeJOUR
atitleFall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial
jtitleThe Lancet (British edition)
addtitleLancet
date2015
risdate2015
volume385
issue9987
spage2592
epage2599
pages2592-2599
issn0140-6736
eissn1474-547X
codenLANCAO
abstractSummary Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Methods Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Findings Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). Interpretation Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. Funding State Health Research Advisory Council, Department of Health, Government of Western Australia.
copEngland
pubElsevier Ltd
pmid25865864
doi10.1016/S0140-6736(14)61945-0
oafree_for_read