Patient education to prevent falls among older hospital inpatients: A randomized controlled trial

Terry P Haines, Anne-Marie Hill, Keith D Hill, Steven McPhail, David Oliver, Sandra Brauer, Tammy Hoffmann, Christopher Beer

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Abstract

BACKGROUND: Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent them.

METHODS: This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews.

RESULTS: Rates of falls per 1000 patient-days did not differ significantly between groups (control, 9.27; materials only, 8.61; and complete program, 7.63). However, there was a significant interaction between the intervention and presence of cognitive impairment. Falls were less frequent among cognitively intact patients in the complete program group (4.01 per 1000 patient-days) than among cognitively intact patients in the materials-only group (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51; 95% confidence interval, 0.28-0.93]) and control group (8.72 per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidence interval, 0.24-0.78).

CONCLUSION: Multimedia patient education with trained health professional follow-up reduced falls among patients with intact cognitive function admitted to a range of hospital wards. Trial Registration anzctr.org.au Identifier: ACTRN12608000015347.

Original languageEnglish
Pages (from-to)516-24
Number of pages9
JournalArchives of Internal Medicine
Volume171
Issue number6
DOIs
Publication statusPublished - 28 Mar 2011
Externally publishedYes

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Patient Education
Inpatients
Randomized Controlled Trials
Multimedia
Health
Confidence Intervals
Control Groups
Geriatrics
Cognition
Medical Records
Orthopedics
Hospitalization
Interviews
Research

Cite this

Haines, T. P., Hill, A-M., Hill, K. D., McPhail, S., Oliver, D., Brauer, S., ... Beer, C. (2011). Patient education to prevent falls among older hospital inpatients: A randomized controlled trial. Archives of Internal Medicine, 171(6), 516-24. https://doi.org/10.1001/archinternmed.2010.444
Haines, Terry P ; Hill, Anne-Marie ; Hill, Keith D ; McPhail, Steven ; Oliver, David ; Brauer, Sandra ; Hoffmann, Tammy ; Beer, Christopher. / Patient education to prevent falls among older hospital inpatients : A randomized controlled trial. In: Archives of Internal Medicine. 2011 ; Vol. 171, No. 6. pp. 516-24.
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Patient education to prevent falls among older hospital inpatients : A randomized controlled trial. / Haines, Terry P; Hill, Anne-Marie; Hill, Keith D; McPhail, Steven; Oliver, David; Brauer, Sandra; Hoffmann, Tammy; Beer, Christopher.

In: Archives of Internal Medicine, Vol. 171, No. 6, 28.03.2011, p. 516-24.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Patient education to prevent falls among older hospital inpatients

T2 - A randomized controlled trial

AU - Haines, Terry P

AU - Hill, Anne-Marie

AU - Hill, Keith D

AU - McPhail, Steven

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AU - Hoffmann, Tammy

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N2 - BACKGROUND: Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent them.METHODS: This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews.RESULTS: Rates of falls per 1000 patient-days did not differ significantly between groups (control, 9.27; materials only, 8.61; and complete program, 7.63). However, there was a significant interaction between the intervention and presence of cognitive impairment. Falls were less frequent among cognitively intact patients in the complete program group (4.01 per 1000 patient-days) than among cognitively intact patients in the materials-only group (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51; 95% confidence interval, 0.28-0.93]) and control group (8.72 per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidence interval, 0.24-0.78).CONCLUSION: Multimedia patient education with trained health professional follow-up reduced falls among patients with intact cognitive function admitted to a range of hospital wards. Trial Registration anzctr.org.au Identifier: ACTRN12608000015347.

AB - BACKGROUND: Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent them.METHODS: This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews.RESULTS: Rates of falls per 1000 patient-days did not differ significantly between groups (control, 9.27; materials only, 8.61; and complete program, 7.63). However, there was a significant interaction between the intervention and presence of cognitive impairment. Falls were less frequent among cognitively intact patients in the complete program group (4.01 per 1000 patient-days) than among cognitively intact patients in the materials-only group (8.18 per 1000 patient-days) (adjusted hazard ratio, 0.51; 95% confidence interval, 0.28-0.93]) and control group (8.72 per 1000 patient-days) (adjusted hazard ratio, 0.43; 95% confidence interval, 0.24-0.78).CONCLUSION: Multimedia patient education with trained health professional follow-up reduced falls among patients with intact cognitive function admitted to a range of hospital wards. Trial Registration anzctr.org.au Identifier: ACTRN12608000015347.

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DO - 10.1001/archinternmed.2010.444

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JO - Archives of Internal Medicine

JF - Archives of Internal Medicine

SN - 0003-9926

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