Prevention of fall-related injuries in long-term care: a randomized controlled trial of staff education.

Ray WA, Taylor JA, Brown AK, Gideon P, Hall K, Arbogast P, Meredith S
Arch Intern Med. 2005 165 (19): 2293-8

PMID: 16246997 · DOI:10.1001/archinte.165.19.2293

BACKGROUND - Fall-related injuries, a major public health problem in long-term care, may be reduced by interventions that improve safety practices. Previous studies have shown that safety practice interventions can reduce falls; however, in long-term care these have relied heavily on external funding and staff. The aim of this study was to test whether a training program in safety practices for staff could reduce fall-related injuries in long-term care facilities.

METHODS - A cluster randomization clinical trial with 112 qualifying facilities and 10,558 study residents 65 years or older and not bedridden. The intervention was an intensive 2-day safety training program with 12-month follow-up. The training program targeted living space and personal safety; wheelchairs, canes, and walkers; psychotropic medication use; and transferring and ambulation. The main outcome measure was serious fall-related injuries during the follow-up period.

RESULTS - There was no difference in injury occurrence between the intervention and control facilities (adjusted rate ratio, 0.98; 95% confidence interval, 0.83-1.16). For residents with a prior fall in facilities with the best program compliance, there was a nonsignificant trend toward fewer injuries in the intervention group (adjusted rate ratio, 0.79; 95% confidence interval, 0.57-1.10).

CONCLUSION - More intensive interventions are required to prevent fall-related injuries in long-term care facilities.

MeSH Terms (17)

Accidental Falls Aged Aged, 80 and over Confidence Intervals Education, Public Health Professional Female Follow-Up Studies Hospitalization Humans Incidence Long-Term Care Male Medical Staff Proportional Hazards Models Retrospective Studies United States Wounds and Injuries

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