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Comparison of a fall risk assessment tool with nurses' judgement alone: a cluster-randomised controlled trial
Gabriele Meyer1, Sascha Köpke, Burkhard Haastert
1Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany. Gabriele.Meyer@uni-wh.de
Background:
the impact of fall risk assessment tools on clinical endpoints is unknown.
Objective:
we compared a standardised fall risk assessment tool alongside nurses' clinical judgement with nurses' judgement alone.
Design:
a 12-month cluster-randomised controlled trial.
Setting:
nursing homes in Hamburg (29 per study group).
Subjects:
1,125 residents (n = 574 intervention group, IG; n = 551 control group, CG).
Interventions:
all homes received structured information on fall prevention before randomisation. The IG monthly administered the Downton Index, and the CG did not use a tool. Measurements were number of participants with at least one fall, falls, fall-related injuries and medical attention, fall preventive measures, physical restraints.
Results:
the mean follow-up was 10.8 +/- 2.9 months in both groups: 105 (IG) and 114 (CG) residents died or moved away. There was no difference between the groups concerning the number of residents with at least one fall (IG: 52%, CG: 53%, mean difference -0.7, 95% confidence interval -10.3 to 8.9, P = 0.88) and the number of falls (n = 1,016 and n = 1,014). All other outcomes were also comparable between the IG and CG.
Conclusions:
application of a fall risk assessment tool in nursing homes does not result in the better clinical outcome than reliance on nurses' clinical judgement alone.
