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Intervention to Prevent Falls on the Medical Service in a Teaching Hospital

Published online by Cambridge University Press:  02 January 2015

Melissa J. Krauss*
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Nhial Tutlam
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Eileen Costantinou
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Shirley Johnson
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Diane Jackson
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Victoria J. Fraser
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
*
Washington University School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, 660 S. Euclid Ave., Campus Box 8051, St. Louis, MO 63110 (mkrauss@im.wustl.edu)

Abstract

Objective.

To evaluate an intervention to prevent falls at a hospital.

Design.

A quasi-experimental intervention with historical and contemporaneous control groups.

Setting and Participants.

Nursing staff and patients in the medicine service (comprising 2 intervention floors and 2 control floors) at an academic hospital.

Intervention.

Nursing staff were educated regarding fall prevention during the period from April through December 2005. Data on implemented prevention strategies were collected on control and intervention floors. Mean monthly fall rates were compared over time and between intervention and control floors, using repeated-measures analysis of variance.

Results.

Postintervention fall knowledge test scores for the nursing staff were greater than preintervention test scores (mean postintervention test score, 91%; mean preintervention test score, 72%; P < .001). Use of prevention strategies was greater on intervention floors than it was on control floors, including patient education via pamphlets (46% vs 15%; P < .001), use of toileting schedules (36% vs 25%; P = .016), and discussion of high-risk medications (51% vs 30%; P < .001). The mean fall rate for the first 5 months of the intervention was 43% less than that for the 9-month preintervention period for intervention floors (3.81 falls per 1,000 patient-days vs 6.64 falls per 1,000 patient-days; P = .043). Comparisons of mean rates for the overall 9-month intervention period versus the 9-month preintervention period showed a 23% difference in the fall rate for intervention floors, but this did not reach statistical significance (5.09 falls per 1,000 patient-days vs 6.64 falls per 1,000 patient-days; P = .182).

Conclusion.

The nursing staffs knowledge and use of prevention strategies increased. Fall rates decreased for 5 months after the educational intervention, but the reduction was not sustained.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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