Joanna Jellett1, Cylie Williams2,3, Diana Clayton1, Virginia Plummer4,5,6, Terry Haines3. 1. Peninsula Health, Falls Prevention Service, Mornington, Victoria, Australia. 2. Peninsula Health, Allied Health, Frankston, Victoria, Australia. 3. School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, Victoria, Australia. 4. School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia. 5. Peninsula Health, Continuous Education & Development Unit, Frankston, Victoria, Australia. 6. School of Health, Federation University Australia, Berwick, Victoria, Australia.
Abstract
AIMS AND OBJECTIVES: To investigate the impact of removing a falls risk screening tool from an overall falls risk assessment programme on the rate of falls, injurious falls and completion of falls prevention activities by staff. BACKGROUND: Falls in older patients are common adverse events in hospital settings. Screening and assessing individual patients for risk of falls are a common, but controversial element of falls prevention strategies in hospitals. DESIGN: A stepped-wedge, cluster-randomised controlled trial using a disinvestment approach. METHODS: This trial was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). All patients were admitted to 20 health service wards (9 units) over the 10-month study period. The control condition contained a falls risk screening tool element, a full falls risk factor assessment and intervention provision section. In the intervention condition, only the full falls risk factor assessment and intervention provision section was applied, and the falls risk screening tool element was removed. Fall rates were extracted from hospital level data, files were audited for tool completion, and nurses surveyed about tool use. RESULTS: There did not appear to be an impact on the falls rate per month when the risk screening tool component was removed (incidence rate ratio (IRR) = 0.84-favours intervention, 95%CI = 0.67 to 1.05, p = .14) nor on the falls rate with serious injury (IRR = 0.90, 95%CI = 0.26 to 3.09, p = .87). There was a thirty-six second reduction of time per patient reported by staff to complete paperwork (p < .001). There was no difference in the proportion of patients for whom the tool was completed, nor the number of falls prevention interventions identified for implementation. CONCLUSION: Removing the falls risk screening tool section did not negatively impact falls and reduced time spent completing falls prevention paperwork. RELEVANCE TO CLINICAL PRACTICE: Falls prevention is an important issue in health services. Removal of a screening risk tool is unlikely to impact falls. This has the potential to reduce nursing administration time that may be otherwise redirected to individual approaches to falls prevention.
RCT Entities:
AIMS AND OBJECTIVES: To investigate the impact of removing a falls risk screening tool from an overall falls risk assessment programme on the rate of falls, injurious falls and completion of falls prevention activities by staff. BACKGROUND: Falls in older patients are common adverse events in hospital settings. Screening and assessing individual patients for risk of falls are a common, but controversial element of falls prevention strategies in hospitals. DESIGN: A stepped-wedge, cluster-randomised controlled trial using a disinvestment approach. METHODS: This trial was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). All patients were admitted to 20 health service wards (9 units) over the 10-month study period. The control condition contained a falls risk screening tool element, a full falls risk factor assessment and intervention provision section. In the intervention condition, only the full falls risk factor assessment and intervention provision section was applied, and the falls risk screening tool element was removed. Fall rates were extracted from hospital level data, files were audited for tool completion, and nurses surveyed about tool use. RESULTS: There did not appear to be an impact on the falls rate per month when the risk screening tool component was removed (incidence rate ratio (IRR) = 0.84-favours intervention, 95%CI = 0.67 to 1.05, p = .14) nor on the falls rate with serious injury (IRR = 0.90, 95%CI = 0.26 to 3.09, p = .87). There was a thirty-six second reduction of time per patient reported by staff to complete paperwork (p < .001). There was no difference in the proportion of patients for whom the tool was completed, nor the number of falls prevention interventions identified for implementation. CONCLUSION: Removing the falls risk screening tool section did not negatively impact falls and reduced time spent completing falls prevention paperwork. RELEVANCE TO CLINICAL PRACTICE: Falls prevention is an important issue in health services. Removal of a screening risk tool is unlikely to impact falls. This has the potential to reduce nursing administration time that may be otherwise redirected to individual approaches to falls prevention.
Authors: Manuel Montero-Odasso; Nathalie van der Velde; Finbarr C Martin; Mirko Petrovic; Maw Pin Tan; Jesper Ryg; Sara Aguilar-Navarro; Neil B Alexander; Clemens Becker; Hubert Blain; Robbie Bourke; Ian D Cameron; Richard Camicioli; Lindy Clemson; Jacqueline Close; Kim Delbaere; Leilei Duan; Gustavo Duque; Suzanne M Dyer; Ellen Freiberger; David A Ganz; Fernando Gómez; Jeffrey M Hausdorff; David B Hogan; Susan M W Hunter; Jose R Jauregui; Nellie Kamkar; Rose-Anne Kenny; Sarah E Lamb; Nancy K Latham; Lewis A Lipsitz; Teresa Liu-Ambrose; Pip Logan; Stephen R Lord; Louise Mallet; David Marsh; Koen Milisen; Rogelio Moctezuma-Gallegos; Meg E Morris; Alice Nieuwboer; Monica R Perracini; Frederico Pieruccini-Faria; Alison Pighills; Catherine Said; Ervin Sejdic; Catherine Sherrington; Dawn A Skelton; Sabestina Dsouza; Mark Speechley; Susan Stark; Chris Todd; Bruce R Troen; Tischa van der Cammen; Joe Verghese; Ellen Vlaeyen; Jennifer A Watt; Tahir Masud Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782
Authors: Meg E Morris; Kate Webster; Cathy Jones; Anne-Marie Hill; Terry Haines; Steven McPhail; Debra Kiegaldie; Susan Slade; Dana Jazayeri; Hazel Heng; Ronald Shorr; Leeanne Carey; Anna Barker; Ian Cameron Journal: Age Ageing Date: 2022-05-01 Impact factor: 12.782