Falls
Conditions
Brief summary
This randomized controlled trial was conducted to evaluate if a personalized fall prevention strategy could reduce fall incidence in elderly hospitalized patients. A total of 320 patients were randomized into two groups. The experimental group received interventions guided by an improved fall risk assessment form and an obstacle physical activity test. The control group received standard hospital care. The primary outcome was the incidence of falls. Secondary outcomes included injury severity, nursing satisfaction, patient compliance, and quality of life.
Detailed description
Falls are a common and serious adverse event among elderly hospitalized patients. While standard risk assessment tools exist, they often fail to capture dynamic risk factors related to patient mobility and environmental interaction. This study aimed to determine if a comprehensive assessment approach could improve fall prevention outcomes. This was a single-center, randomized controlled trial. A total of 320 inpatients aged 65 and older were randomly assigned to either an experimental group or a control group. The experimental group was assessed using an Improved Risk Assessment Form for Inpatient Falls and a novel Obstacle Physical Activity Ability Test. The results guided a personalized fall prevention plan, including targeted exercises and environmental modifications. The control group received the hospital's standard fall prevention care, which included a standard risk checklist and universal precautions. The study's main objective was to compare the incidence of falls between the two groups throughout their hospital stay. Other outcomes, such as injury severity, patient satisfaction, compliance with preventive measures, and quality of life, were also assessed to evaluate the broader impact of the intervention.
Interventions
BEHAVIORALPersonalized Fall Prevention Program
An intervention package featuring a comprehensive, multidimensional risk assessment using an improved form and a dynamic functional test (Obstacle Physical Activity Ability Test). The assessment guided the development of a personalized prevention plan, including targeted exercises, environmental adjustments, and enhanced patient/family education.
BEHAVIORALStandard Fall Prevention Care
Standard hospital care for fall prevention, including universal precautions (e.g., clutter-free environment, non-slip footwear) and risk assessment using a standard hospital checklist.
Sponsors
The First Hospital of Hebei Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Inpatients aged 65 and above. * Identified as being at risk of falling upon admission screening (defined as having at least one of the following: history of a fall in the last 6 months, use of a walking aid, or observed gait/balance instability). * Able to provide informed consent or have a legal guardian provide consent.
Exclusion criteria
* Acutely life-threatening conditions or severe cardiorespiratory instability that would preclude any mobility testing. * History of a severe fall-related injury (defined as a fracture or head injury requiring hospitalization) in the past 6 months that currently limits mobility assessment. * Non-ambulatory or bed-bound patients. * Patients with severe dementia (e.g., Mini-Mental State Examination score \< 10) or diagnosed psychiatric conditions (e.g., psychosis, severe agitation) that would prevent cooperation. * Expected hospital stay of less than 48 hours.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fall Incidence | Through study completion, an average of 10 days | The proportion of patients experiencing one or more falls. A fall was defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. It was recorded through the hospital's incident reporting system, patient self-report, and daily nursing checks. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severity of Fall-Related Injury | Through study completion, an average of 10 days | Classification of injuries sustained from a fall, categorized by a physician as: no injury, minor injury (e.g., bruises, abrasions), or major injury (e.g., fracture, head injury with loss of consciousness, laceration requiring sutures). |
| Nursing Satisfaction | At discharge (an average of 10 days post-admission) | Patient-reported satisfaction with nursing communication, responsiveness, and fall prevention education, measured using a 5-item institutional survey on a 10-point scale. |
| Patient Compliance | Through study completion, an average of 10 days (assessed weekly) | Adherence to prescribed fall prevention precautions, assessed via a 10-item observational checklist of precautions (e.g., using call bell, bed in low position). Compliance was categorized based on the percentage of items adhered to. |
| Change in Physical Activity Ability | Baseline and at discharge (an average of 10 days) | Change in physical mobility from admission to discharge, categorized by the treating physical therapist as Improved markedly, Improved, No change, or Reduced, based on clinical judgment and performance on the obstacle test. |
| Change in Quality of Life (QoL) | Baseline and at discharge (an average of 10 days) | Change in QoL from admission to discharge, measured by the mean change in a 10-point global QoL rating from a structured, non-validated questionnaire covering physical, psychological, and social domains. The scale is a 10-point global Quality of Life rating questionnaire, with a range from 1 (worst possible quality of life) to 10 (best possible quality of life). A higher score indicates a better outcome. |
Countries
China
Outcome results
None listed