This study was designed to evaluate the effectiveness of a multifactorial intervention on incidence of falls in psychogeriatric nursing home patients.
Design: cluster-randomised controlled 12-month trial.
Setting: psychogeriatric wards in 12 nursing homes in The Netherlands.
Participants: psychogeriatric nursing home patients (n = 518).
Intervention: a general medical assessment and a specific fall risk evaluation tool were employed by a multidisciplinary fall prevention team, resulting in general and individual fall prevention activities.
Results: there were 355 falls in 169.5 patient-years (2.09 falls per patient per year) in the intervention group and 422 falls in 166.3 patient-years (2.54 falls per patient per year) in the control group. Intention-to-treat analysis with adjustment for ward related and patient-related parameters, and intra-cluster correlation, showed that the intervention group had a significantly lower mean fall incidence rate than the control group (rate ratio = 0.64, 95% CI = 0.43–0.96, P = 0.029). Subgroup analyses showed that fall risk declined further as patients participated longer in the intervention programme.
Conclusion: the introduction of a structured multifactorial intervention to prevent falls in psychogeriatric nursing home patients significantly reduced the number of falls. The authors concluded that the reduction was substantial and of high clinical relevance.
Available at: Jacques et al.2009
