Citation

Ray WA, Taylor JA, Brown AK, Gideon P, Hall K, Arbogast PG, Meredith S. Arch. Intern. Med. 2005; 165(19): 2293-2298.

Affiliation

Division of Pharmacoepidemiology and Center for Education and Research on Therapeutics, Department of Preventive Medicine, Vanderbilt University School of Medicine, and VA Tennessee Valley Healthcare System, TN, USA.

Copyright

(Copyright © 2005, American Medical Association)

DOI

10.1001/archinte.165.19.2293

PMID

16246997

Abstract

BACKGROUND: Fall-related injuries, a major public health problem in long-term care, may be reduced by interventions that improve safety practices. Previous studies have shown that safety practice interventions can reduce falls; however, in long-term care these have relied heavily on external funding and staff. The aim of this study was to test whether a training program in safety practices for staff could reduce fall-related injuries in long-term care facilities. METHODS: A cluster randomization clinical trial with 112 qualifying facilities and 10 558 study residents 65 years or older and not bedridden. The intervention was an intensive 2-day safety training program with 12-month follow-up. The training program targeted living space and personal safety; wheelchairs, canes, and walkers; psychotropic medication use; and transferring and ambulation. The main outcome measure was serious fall-related injuries during the follow-up period. RESULTS: There was no difference in injury occurrence between the intervention and control facilities (adjusted rate ratio, 0.98; 95% confidence interval, 0.83-1.16). For residents with a prior fall in facilities with the best program compliance, there was a nonsignificant trend toward fewer injuries in the intervention group (adjusted rate ratio, 0.79; 95% confidence interval, 0.57-1.10). CONCLUSION: More intensive interventions are required to prevent fall-related injuries in long-term care facilities.