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Falls risk score removal does not impact inpatient falls: A stepped‐wedge, cluster‐randomised trial

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  • Joanna Jellett
  • Cylie Williams
  • Diana Clayton
  • Virginia Plummer
  • Terry Haines

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

Suggested Citation

  • Joanna Jellett & Cylie Williams & Diana Clayton & Virginia Plummer & Terry Haines, 2020. "Falls risk score removal does not impact inpatient falls: A stepped‐wedge, cluster‐randomised trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(23-24), pages 4505-4513, December.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:23-24:p:4505-4513
    DOI: 10.1111/jocn.15471
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    References listed on IDEAS

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    1. Bruno Roza da Costa & Anne Wilhelmina Saskia Rutjes & Angelico Mendy & Rosalie Freund-Heritage & Edgar Ramos Vieira, 2012. "Can Falls Risk Prediction Tools Correctly Identify Fall-Prone Elderly Rehabilitation Inpatients? A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
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    1. Terry P Haines & Mari Botti & Natasha Brusco & Lisa O’Brien & Bernice Redley & Kelly-Ann Bowles & Alison Hutchinson & Debra Mitchell & Joanna Jellett & Kate Steen & Leanne Boyd & Melinda Webb-St Mart , 2021. "Disinvestment in the presence of uncertainty: Description of a novel, multi-group, disinvestment trial design and protocol for an application to reduce or cease use of mobilisation alarms for preventi," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-17, December.
    2. Elissa Dabkowski & Simon J. Cooper & Jhodie R. Duncan & Karen Missen, 2022. "Exploring Hospital Inpatients’ Awareness of Their Falls Risk: A Qualitative Exploratory Study," IJERPH, MDPI, vol. 20(1), pages 1-14, December.

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