Effectiveness of a multi-factorial, evidence-based approach to Falls Reduction in Residential Aged Care Facilities.

The intervention is a multifactorial strategy that addresses falls risk at an individual resident and systems level. The main engine for the intervention is the falls project officer who will liase with intervention facilities to determine their current approaches to falls prevention and to facilitate the adoption of falls prevention strategies that have been found to be effective in other settings. These strategies include falls risk assessment, reduction of environmental hazards, physical activity, calcium and vitamin D supplementation, general nutrition, medication review, review of restraint policy.Evaluation of the intervention will involve a number of low and high care lodges from residential aged care facilities across the Hunter and enable comparison of outcomes for residents in lodges that are allocated to receive the intervention and control lodges. Because the intervention is holistic and is aimed at the environment and culture surrounding the residents, whole facilities (lodges) will be selected for random allocation to intervention or control conditions. Randomisation will occur using a technique of minimisation to ensure intervention and control lodges are balanced for: number of residents, level of care, and dementia specific units. A total eighty lodges will be randomly allocated in this way, with a minimum of 20 residents per lodge.Baseline measures will be collected over four months. This will be followed by a one month washout period when staff in the intervention facilities are trained in the intervention. The intervention will then be implemented for a 12 month period to allow for monitoring of the impact of the intervention on falls risk and other outcomes.Following randomisation and prior to administration of the intervention, a census of non respite residents will be undertaken and these will form the intervention and control cohorts that will be followed.