A cluster randomized trial 1 compared fall rates in 4 urban US hospitals in units that received usual care (4 units, 5104 patients) or the intervention (4 units, 5160 patients). The intervention consisted of an IT application that provided the Morse Falls Scale, suggestions for tailored interventions based on the patient's determinants of fall risk, documentation template for the interventions, and bed posters, patient education handouts, and plans of care, all communicating patient-specific alerts to key stakeholders. During a 6-month intervention period there were 67 falls in the intervention units and 87 falls in the control units (p=0.02); the site-adjusted fall rate was 3.15 per 1000 patient days (95% CI 2.54 to 3.90) in the intervention units, and 4.18 (95% CI 3.45 to 5.06) in the control units, p=0.04. The effect was confined to patients older than 65 years. No significant effect was noted in fall-related injuries (7 in the intervention units, 9 in the control units). The NNT for preventing one fall in one patient day was 862, or 287 during a typical 3-day stay.
Comment: The quality of evidence is downgraded by study limitations (assessment of falls was carried out by the caregivers who provided the interventions).
Primary/Secondary Keywords