Table 2 Study characteristics
First author, publication year, country | Study design, setting | Participant eligibility criteria, sample size (n) | Falls intervention characteristics | Intervention outcomes (primary) | |||||
|---|---|---|---|---|---|---|---|---|---|
Type | Intervention components | Baseline assessment of staff and/or facilities | Duration (weeks) | Control | Clinical outcome/ Fall-related outcome | Staff-related outcome | |||
Bonner 2007, US [46] | Pre-post-test, LTCF | •Single-site facility •Staff: all staff (178): 8 nurses; 40 CNAs; 20 non-licensed personnel; total n = 68 •Residents: N/R | MCI | •Educational intervention •Falls champion •Weekly interdisciplinary rounds | •10-item knowledge test developed by investigators • Fall rates (a month prior) | •I: 9 wks • F: None | N/A | Fall rates (falls/100 residents per month): Pre-test: 16.1%. At 30 days: 12.3%. At 60 days: 9% | Staff knowledge test: pre-test score of 86.78%; 60-day mean post-test score of 90.69% |
Gama 2011, Spain [47] | QI (pre-post-test), NH | •Single-site facility •Residents: those who could walk 5 m independently; n = 127 •Staff: “staff of the institution” (n: N/R) | MFI | QI cycle including: •Local building & piloting of quality criteria (4 structural and 9 process) •Specific interventions involving educational activities; Change process and record systems | •13 criteria for quality of fall prevention were assessed •Fall occurrences: in a 60 randomly selected residents (recorded 6 months prior) | •I & F: 26 wks | N/A | Fall numbers: 53 falls in a year; pre-intervention: 32, post-intervention: 21 | |
Leverenz, 2018, US [48] | Pre-post-test pilot study, LTCF | •Single-site facility •Staff: Full-time nursing staff who completed the education session; n = 8 (6 CNAs; 1 LPN; 1 RN) •Residents: N/A | SI | •Staff education & training course with 6 LTCF learning modules/fall prevention content areas: vision; assistive devices; environment; pressure and motion alarm; mobility; therapeutic use-of-self | Staff self-efficacy using SEPF-A and SEPF-N scales | •I: 5 wks • F: None | N/A | N/A | •SEPF-N cumulative average score (n = 6/8): pre-training: range 18 to 48; post-training: range 31 to 48 •SEPF-A cumulative average score (n = 2/8): pre-training: range 19 to 24; post-training: range 34 to 48 |
Rask., 2007, US [49] | QI, NHs | 19 NHs (initially 9; plus 10 after 4 months); 23 control NHs •Staff: FMP team involved a PT or OT, 2–4 nursing assistants, a maintenance member and a director of nursing (n: N/R) •Residents: all residents of participating NHs (n: N/R) | MCI | •Organisational leadership buy-in and support •Facility preparation-based falls coordinator and MDT •Intensive training and education •Ongoing consultation & oversight by advanced nurse experts in FMP team | Data on falls from MyInnerView quality improvement software in Georgia that enabled the examination of data for intervention and non-intervention facilities | •I & F: 26 wks | Usual care | •Fall rates (falls/100 residents per month): IG: stable (17.3 to 16.4); CG: increased 26% from 15.0 to 18.9 •The level of physical restraint: decreased in both groups; IG: 7.9% to 4.4%; CG: 7.0% to 4.9% | |
Jackson, 2016, US [50] | QI (pre-post-test), NH | •Single-site facility, 150 beds in a suburban area •Residents: all except dementia unit; n = 123 •Staff: convenience sample of 10 staff (4 nurses, 4 nurse aides, 2 therapists) who provided direct patient care (employed full-time for at least six months at NH) | MCI | Included recommendations of the Agency of Healthcare Quality and Research (AHRQ) •Mobility training conducted by PT for all staff and FT •Hourly staff rounding on residents • Physical therapy: Residents encouraged to participate in activities outside of their rooms •Post-fall assessment | •Staff knowledge questionnaire from AHRQ •Data abstraction of fall characteristics | •I: 17 wks • F: None | N/A | •Fall rates: Mean monthly scores pre-I (24.5), post-2-month (13.5), post-4 -months (9.5; 54% decrease in 4 months) •BRIGGS fall risk assessments (newly admitted residents; duration: 4 months): 76% had a high risk of falls •Fall characteristics: 54% occurred by day, 37% evening and 9% at night. 60% fell in own rooms, 28% in dayroom, 4% in dining room, 4% in hallway •42% had fall-related injuries, of which 11% fractures, 21% skin tears, 16% lacerations and 53% haematomas | Staff knowledge test: The average score on the pre-test was 74, and after 2 months, it was 90; after 4-month post-testing, it was 92 |
Szczerbinksa, 2010, Poland [51] | Pre-post-test, NHs | •3 NHs •Residents: all residents of NHs unless unable to walk or cognitive/behavioural issues or medical CI to exercise. NH A: n = 94 residents; NH B: n = 88, NH C: n = 40; total n = 222 •Staff: all staff in NHs (nurses, care assistants, PT); n = N/R | MFI | EUNESE intervention: broad staff involvement in falls risk assessment and referral to exercise programme •Staff training •Exercise intervention •Nurses and care assistant staff conducted the intervention in NHs A and B, PTs in NH C | •The percentage of residents able to walk (assisted or unassisted) •The ratio of staff to residents •The safety index against falls | •I: 52 wks •F: 26 wks | N/A | •Fall incidence: 144 falls: NHA = 53, NHB = 60, NHC = 31 •Falls per month per 100 residents: NHA = 53.5, NHB = 45.8, NHC = 67.4 •Falls incidence medians (pre- vs implementation vs follow-up): NHA: 5.05 vs 2.52 vs 0.50; H = 8.84, p < 0.05 NHB: 4.58 vs 0.38 vs 1.90; H = 8.52, p < 0.05 NHC:3.26 vs 5.43 vs 1.08; H = 3.94, ns | |
Colon-Emeric, A 2006, US [52] | QI (pre-post-test), NHs | •36 NHs; 353 non-intervention NHs •Staff: 2–3 per facility (nursing, administration, PT, pharmacy) (n = unknown) •Residents: residents in each facility (n = 832) | SI | •Staff education and monthly teleconferences using Change Package emphasised fall-risk screening, labelling and risk-factor reduction | Chart abstraction of falls data (IG only) | •I: 39 wks •F: None | Usual care | •Fall rates: IG: pre: 18.2%; post: 15.4%; CG: pre: 12.3%; post: 11% (p = .56) Fall rates (per 1,000 resident-days): Self-report data: 6.1 to 5.6 falls; p = .31; Chart abstraction: 28.6% to 37.5%, p = .17 •Falls screening increased from 51 to 68% (P < .01); Vitamin D prescriptions 40% to 48%, P < .05; use of sedative-hypnotics 19% to 12%, P < .01 | |
Wongrakpanich, 2018, US [53] | QI (pre-post-test), LTCF | •Single-site facility •Resident participants: all aged 65 + , residing in the facility; no exclusion criteria (n = 32) •Staff participants: all staff participated (PTs, geriatricians and RNs participated) (n = 12) | MFI | “STOP-FALLING” checklist included: •Vitamin D supplementation •Patient & family education •Orthostatic vital signs •Physical therapy •Hearing aids and evaluation •Medication review •IN-room safety evaluation •Glasses and vision evaluation | Fall rates, the number of fall-related injuries (minor and major) and recurrent falls (3 months prior) | •I: 13 wks •F: None | N/A | •No. of falls: pre: 22 fallers; post: 13 •Fall-related injuries: pre: 13 (1 major, 12 minor); post: 8 (minor: 8, major: 0) •Fall rate: 2.80 to 1.65 falls/person-year •No. frequent fallers: 5.00 to 2.30/mo.; P < .001, 95% CI 1.78–3.56 •No. falls without injuries: (3.00 to 1.67/mo.; P < .001, 95% CI 0.69- 1.97), •No. minor injuries (4.00 to 2.67/mo.; P < .015, 95% CI 0.14- 2.52) •No. major injuries (0.33 to 0.00/mo.; P < .001, 95% CI 0.13–0.53) | |
Cooper, 2017, Scotland [54] | QI, NH | •Single-site facility •Residents: newly admitted (n = 29) •Staffs: “staff in facility” (n = 31) | MFI | •Staff training- implement/test tool, reflect on changes; ‘driver’ diagram •Fall champions •Fall leadership •Family involvement •Post-fall huddles | •Fall rate and characteristics (3 months prior) | •I: 26 wks •F: None | N/A | • Fall rate (per 1,000 occupied bed days): Mean: 49 to 23, demonstrating an improvement of 36.3% | |
Zubkoff, 2019, US [55] | QI, SVH | •26 SVHs •Residents: elderly, 96% male; (n = unknown) •Staff: Falls teams in each facility: team leader; senior-level support person; nurse, physician or nurse practitioner champion; physical therapist pharmacist; (n = N/R) | MCI | ‘Virtual breakthrough series’ (VBTS) model (27 interventions) with •Webinar for staff education •Open discussion sessions •Coaching •Mentoring •Fall champion •Leadership | •Baseline report of the MDT, planned aims and current fall prevention efforts •Fall rate (prior 6 months) | •I: 26 wks •F: 26 wks | N/A | (5 sites excluded as submitted less than 50% of the monthly data) •Fall rates (/100 days): pre: 28.5; during: 29.2 (p > 0.238); after: 27.5 (p > 0.136) •Fall injury rate (/100 days): pre: 7.4, during: 6.6 (p = 0.009); after: 5.6 (p = 0.005) •Minor injury rate (/100 census days): pre: 6.4; after: 5.8 (p = 0.000) | |
Beasley, 2009, Australia [56] | QI, LTCF | •56-bed single-site catering for high- & low-care, incorporating a 6-bed secure dementia unit •Residents: all at medium/high fall risk on admission (n = 20) •Staff: Enrolled nurses & care staff on duty over 3 days (n = 20) | MFI | •Audit and feedback process using a PACES-JBI software programme •Practice standards, evidence-based strategies (education intervention for staff and residents, medication review, environmental assessment, fall risk assessment) | Baseline audit: •Staff attendance at fall prevention training 12 months prior •Falls data | •I: 20 wks •F: None | N/A | •No. falls per month: pre-intervention: 21–23 post-intervention: 12 | |
Hofmann 2003, US [59] | Pre-post-test; NH | •Single-site (not-for-profit) •Residents: older people, 55% aged over 85 years (n = 120) •Staff: multiple disciplines from the facility (n: N/R) | MCI | •Environmental actions •Incorporating additional staff through shift changes •Restorative Activity Programme | • Fall rate: fall incidence from medical records (a year prior) | •I: 52 wks •F: 52 wks | N/A | •No. falls: pre: 479 falls; post: 299 falls; total reduction: 38% (P = 0.0003) •No. & rate of fractures: pre: 16, 3.3% fracture rate; post: 8, 2.7% fracture rate, total reduction: 50% •Fall rates by shift: 1. 7AM-3PM shift: pre: 167; post: 155 2. 3-11PM: pre: 221; post: 115; 63% had fractures 3. 11PM-7AM: pre: 91; post: 29 •Recurrent fallers: pre: N/A; post: 13 individuals (range: 2–9 falls); 20% of total no. of falls | |
Pre-post-test, SNF | •Single-site, 156-bed skilled nursing home •Residents: long-stay only (n = 145) •Staff: ‘all staff at facility (n: N/R) | MFI | •Staff training •Post-fall assessment •Case management intervention for fall-risk residents •Exercise •Bed transfer | •Fall incidence (27 weeks prior) | •I: 27 wks •F: None | N/A | •No. falls: pre: 207 falls; post: 173 falls •Av. weekly census: pre: 137.4 (0.0609 falls/resident/week); post: 141.34 (0.0473 falls/resident/week) •Fall rate: pre: Mean: 0.060, SD: 0.022; post: Mean: 0.047, SD: 0.026; paired t-test: p = 0.0486; Chi-Square test: p = 0.009 •Fall occurrence by shift: evening (51%); day (31%); night (18%) •Fall occurrence details: ambulating (70%), 25% fell from chair, wheelchair or commode; 5% due to ‘various causes ‘ | ||
Kato, 2008, Japanese [58] | Action research, pre-post-test, LTCF | •Two wards in a single-site •Residents: older (IG: 31; CG: 20) •Staff: nurses and caregiving staff members; (IG: 14; CG: 10) | MFI | •Staff education •Assessment of individual risks • Care adapted to risks •Consultation about fall-related problems •Modification of care when falls | •The number of falls and injuries (6 months prior) •The Generalized Self-Efficacy Scale and the Social Support Scale for staff | •I: 26 wks •F: None | Usual care | •No. falls: IG: pre: 37; post: 27; CG: unchanged •Fall rate per 1,000 residential days: IG: 7.6 to 5.0; CG: 4.8 to 4.3 •No. fallers: IG: 11 (35.5%) to 14 (45.2%); CG: 6 (30.0%) to 7 (35.0%) •No. injuries: IG: reduced from 13 (41.9) to 3 (9.7%); CG: unchanged •No. injured persons: IG: 7 (22.6%) to three (9.7%); CG: two to three •Falls occurrence: pre: RR: 1.283 (95% CI: 0.384–4.289); post: RR: 1.529 (95% CI: 0.480–4.877) | Av. Generalized Self-Efficacy Scale score: •IG: pre: 69.1 +—7.0; post: 74.1 +—6.1 •CC: pre: 70.1 +—12.9; post: 67.4 + -9.9 Av score on the Social Support Scale: •IG: pre: 66.1 +—11.3; post: 69.8 +—12.0 •CC: pre: 70.0 +—9.3; post: 63.0 +—11.0 |
Jensen, 2002, Sweden [60] | CRCT, LTCF | •9 facilities; IG = 4, CG = 5 •Residents: aged 65 + , selected in a cross-sectional manner; (n = Baseline: IG = 208, CG = 194) (n = follow-up: IG = 167; CG = 157) •Staff: Permanent staff (273 nurses’ aides, 20 registered nurses & ext. employees, 8 PTs during int., 3 PTs at follow-up) | MFI | •Staff education •Environmental modification •Exercise •Supply or repair of aids •Change in medication •Hip protectors •post-fall problem-solving conferences | •Resident baseline assessment •All nurses were interviewed to determine the use of physical restraints and the number of falls (6 months prior) | •I: 11 wks •F: 34 wks | Usual care | •No. residents with falls: IG: 82/188; 44%; CG: 109/196; 56%; RR .78 (CI, 0.64–0.96); adjusted OR 0.49 (CI,0.37–0.65) •No. falls: IG: 273/40898 on observation day; CG:346/41590 observation day •Incidence of falls (/1,000 person-days): IG: 6.7; CG: 8.3; adj. incidence rate ratio 0.60(CI, 0.50 to 0.73) •Time to first fall: adj hazard ratio 0.66 (CI,0.50 to 0.79) | |
Kerse, 2004, New Zealand [61] | CRCT, LTCF | •Sites selected by dependency level: 8 high-level, 4 low-level, 2 high-level units with secure dementia units (IG = 7; CG = 7) •Residents: All older people with low or high-level dependency (n = Baseline: IG = 241; CG = 312; follow-up: IG = 177; CG = 239) •Staff: existing staff of each facility (n = N/R) | MFI | •Systematic, individualised fall-risk management using existing staff and resources •Using a fall-risk assessment tool •Using a high-risk logo for residents deemed to be at high risk of falling •Staff education (2–4 h) | •Resident demographic information •Dependency levels (composites for mobility, behaviour and self-care) •Falls and fall-related injuries (3–5 months prior) | I and F: 52 wks | Usual care | •No. falls: IG: 173(56%), CG: 103 (43%) (p < .018) during the int. period •Incidence rate of falls: IG > CG (adj. IRR = 1.34, 95% CI = 1.06–1.72) during int •No. fall-related injuries: 199 residents (26%) and 72% of fallers sustained injuries; 47 were serious injuries (IG = 34, CG = 20; 5 had > 1 serious injury) •Fall- injuries rate (adj. IRR 1.12.CI, 0.85–1.47) and fall-related serious injury rate (adj. IRR 1.14.CI, 0.61–2.13) p = NS | |
Ray., 2005, US [62] | CRCT, LTCF | •112 facilities (IG = 56; CG = 56) •Residents: Aged 65 + , not bedbound; (IG: 4,932, CG:5,625) •Staff: fall teams appointed in each facility: nurse, 1–2 CANs, an OT, a PT and an engineer (n = N/R) | SI | Staff training (2 days) on 4 safety domains: living space and personal safety; wheelchairs, canes and walkers; psychotropic medication use; and transferring and ambulation | •Demographic info, mobility levels, falls history, psychotropic medication – from Mandatory Minimum Data Set (a year prior) •LTCF records to verify residence in the facility | I and F: 52 wks | Usual care | •Fall-related injuries (person-years): 838/8,172 first injuries occurred; 270 were hip/femur fractures; 240 were other fractures; 328 were other injuries • Occurrence injuries between groups (/1,000 person-years): IG: 106 injuries; CG: 99.5 (Adj. RR, 0.98; 95% CI, 0.83–1.16) | |
Meyer, 2009, Germany [63] | CRCT, NHs | •29 NHs per study group, with at least 30 residents, not using a fall risk assessment tool •Residents: aged 70 + , able to walk without assistive devices (n = 574 IG; n = 551 CG) •Staff: nursing staff attending the educational session | SI | •Education session (60–90 min) on fall risk assessment and using the Downton Index | •Baseline characteristics of clusters and resident participants •Cluster adjustment of data avoided to present the raw baseline characteristics of the study population | I and F: 52 wks | Education without Down Index tool | •No. residents with > 1 fall: IG: 52%; CG: 53%, p = .88 •No. falls: IG: 1,016; CG: 1,014 •Mean incidence of first fall (/month): IG: 0.084 ± 0.046; CG: 0.082 ± 0.042 (P = 0.85) •Mean incidences, all falls (/month): IG: 0.162 ± 0.108; CG 0.167 ± 0.084 (P = 0.57) | |
CRCT, NHs | •24 NHs, IG = 12, CG = 12 •Staff: All full-time staff able to understand English (n = IC: 658; CC: 743) •Residents: aged 65 + with > 1 fall in either data collection window and remained in facility for > 30 days after (n = IG: 887; CG: 907) | MCI | •CONNECT programme: 3 main components, delivered over 3 months: CONNECT and learn protocol; relationship mapping; unit-based mentoring protocols •Followed by a FALLs programme delivered over 3 months: training session and team teleconference meetings, staff education, post-fall problem solving, audit & feedback | •Staff surveys (openness, communication, accuracy, timeliness); Participation in Decision-making Instrument; Safety Organizing Scale; Local Interaction Scale; Perceived Quality of Care Scale (2 wks. prior) •Random 50 residents/site: medical records (6 mths prior) | •I: 39 wks •F: None | FALLs programme only | O measurements: 3 months after CONNECT; 3 months after FALL; (3 months after completing interventions) •Recurrent fall rate: IG: 4.06, IQR, 2.03–8.11; CG: 4.06, IQR, 2.03–8.11 •Injurious fall rates (/resident/year): IG: IQR, 0–2.21, Mean 2.07, SD (4.56); CC: 0–2.12, Mean 2.07; SD (4.56) (no diff) •Fall risk reduction activities: IG: Mean 3.3, SD 1.6; CG: Mean 3.2, SD 1.5 | Staff surveys (openness, communication, accuracy, timeliness); Participation in Decision-making Instrument; Safety Organizing Scale; Local Interaction Scale; Perceived Quality of Care Scale: completed by 1,545 unique staff members, including IG:734 (37%); CC: 811 (44%); the findings were significant only for the improvement in staff communication timeliness measure: 0.8 [SE,0.03] points on a 5-point scale; p = .02 | |
Ward, 2010, Australia [65] | CRCT, LLTCF | •88 aged care facilities; n = IG: 46; CG: 42, 6 of whom withdrew •Residents: older, mixed patient type (high-care, low-care and dementia-specific) (n = 5391) •Staff: all staff (n = N/R) | SI | •Employment of project nurse to encourage staff in fall prevention interventions (risk assessment, mobility assessment, hip protectors, calcium and vit. D supplements, continence management, exercise programmes, appropriate footwear, medication review, post-fall management review | •The number of falls, fall-related injuries (fracture, hospitalisation and death) (7 months prior) | •I: 74 wks •F: None | •Usual care | •Vit D (/100 beds): pre: IG: mean 6.7 (95% CI, 1.2 to 10.9); CG mean 12.7 supplements (95% CI, 7.4 to 18.1); post: mean 2.0 supplements (P < 0.001) •Hip protectors (/100 beds): pre: 5.1 both groups (95% CI, 3.1–7.0); post: both increased: first stage slope, 0.25 (95% CI, 0.06–0.43; P = 0.008); second stage slope, 0.29 (95% CI, 0.17–0.41; P < 0.001) •Falls rate (/100 beds/month): no change either group 16.0 (95% CI, 14.2–17.9); pre: (0.14 falls; 95% CI, − 0.17–0.45; p = 0.37); post: (− 0.023 falls; 95% CI, − 0.14- 0.09; p = 0.686) •No. femoral fractures: CG: 106; IG: 109 •Rates femoral neck fractures: similar in both groups (p = 0.8) •Overall, no difference in groups regarding no. of falls & related injuries | |
Bouwen, 2008, Belgium [66] | CRCT, NHs | •10 nursing wards from 7 NHs; n = CG: 5 wards; IG: 5 wards •Residents: all ‘conscious’ residents; n = IG: 210; CC: 169 •Staff: all staff nurses (n = N/R) | MCI | •Staff training on risk factors for falls •Environmental modification •Use of fall diaries | •Questionnaire: fall risk factors, chronic medication and co-morbidity (IG only) •Baseline assess: mobility (TUGT), cognition (MMSE) •Accidental falls: (6 months prior); both groups | •I: 6 wks •F: 26 wks | •Usual care | •No. falls (at least once): pre: IG: 44/210 (21%). CG: 20/169 (12%); post: IG: 28/203 (14%); CG: 38/158 (24%) •Difference between av. no. falls in the two groups: (p = 0.10); (OR: 0.46 (95% CI = 0.26–0.79) | |
Lomax, 2020, US [67] | QI, pre-post-test, SNF | •164-bed single-site: skilled nursing, rehabilitation and respite care services (75% in LTCF) •Residents: aged 65 + in LTCF part •Staff: convenience sample: RNs and CNAs (n = N/R) | SI | •Staff education to implement post-fall huddles | •Demographics and characteristics of residents; fall data at baseline | •I: 8 wks •F: None | N/A | •No. falls: pre: 68/164 (75.6%); post: 22/164 (24.4%) •Timing of fall: night shifts (pre: n = 43,47.8%; post: n = 31,45.6%; p < .732) •Precipitants: walking, leaving beds, using wheelchairs •No. staff on unit: pre: 1–2 members (n = 31, 45.6%), 2–3 (n = 20, 29.4%), 3–4 (n = 10, 14.7%), 4–5 (n = 7, 10.3%); post: 1–2 (n = 12; 54.5%), 2–3 (n = 7, 31.8%), 34 (n = 2, 9.1%), 4–5 (n = 1, 4.6%); p < .724 | |
Wells, 2011, US[71] | Pre-post-test, SNF | •3 units (single-site facility) •Residents: required total care or rehab services (n = 180) •Staff: CNAs (n = 90); had to complete pre-post-test and attend educ. (n = 42) to be included in analysis | SI | • Staff education | •Staff knowledge and attitude survey developed by investigators •No. falls (3 months prior) | • I: 13 wks •F: 13 wks | N/A | O: at 3 months and 6 months •No. falls: pre: 109 fallers; post: 86 fallers, F: 52 fallers •Fall rate: reduced (52%) | Staff knowledge test: The pre-post score was improved, p = .322 |
Ofosuhen, 2021, US [68] | QI (pre-post-test), LTCF | •Single-site: nursing, non-nursing and residential care •Staff: all RNs & LPNs (n = 55) •Resident: aged 65 + (n = 120) | SI | •Staff education using the STEADI Fall Risk Assessment Toolkit | •Staff nurse knowledge using survey regarding STEADI (a week prior) •Falls rate (3 months prior) | • I: 4 wks • F: None | N/A | •Fall rate (%): pre: 59.8%; post: 23.3% •Av. no. fallers (/month): pre: 19 fallers; post: 7 fallers | Staff knowledge test: pre-test: 12 out of 55 (21.8%) had correct responses to all 13 questions; post-test: 96.3%; Pre-post-test comparison: 75% increase in staff knowledge |
Hurst, 2019, US [72] | Capstone project (pre-post-test), LTCF | •Single-site (169 beds) •Residents: aged 65 + , need assistance ADL or skilled care, > 1 prior fall (n = 154) •Staff participants: all staff (n: N/R) | MCI | •Staff education to implement the Morse Fall Scale Assessment Tool, identifying fall risks and developing a care plan •Falls champion | •The fall rate (3 months prior) • Resident demographic data | •I: 13 wks F: None | N/A | •The fall rate: pre-intervention: 59 falls (10.4%) post-intervention: 29 falls (5.1%) | |
Ogundu, 2016, US [69] | Pre-post-test, SNF | •Single-site; 100-bed, for-profit •Staff: full-time, part-time or per diem nursing staff, trained on the hourly rounding and bed alarm intervention (n = 40) •Residents: N/R | MCI | •Staff education •Implementation of hourly rounds •The use of bed alarms | •No. falls (5 months prior) | • I: 26 wks •F: None | N/A | •No. falls: pre: post: •Fall rate by shift: night shift: pre: post: day shift: pre: post: evening shift: pre: post: •%, residents with any fall: pre: 36.1%; post-: 22.8% | |
Aguwa, 2019, US [70] | Pre-post-test, LTCF | •Single-site •Staff: all nursing & nursing assistant staff (28/46 members: 7 nurses, 21 nursing assistants) •Residents: aged 65 + (n = 114) | SI | •Staff education using the AMDA fall prevention guideline and the STEADI Fall Risk Assessment Toolkit | •Staff self-efficacy using SEPF-N and SEPF-A scales | •I: 26 wks •F: None | N/A | N/A | Staff self-efficacy: Pre-test: 25% nurses didn’t give direct report to NA about residents’ fall risk, or info. on how to prevent falls. 40% of NAs said they didn't receive a verbal report about residents’ fall risk; 90% didn’t receive info. on fall prevention Post-test: All nurses said they would include fall prevention strategies into their communication and shift changes. All nurses agreed to improve teamwork. Self-confidence of nurses and NAs improved (90% & 100%, respectively) |