Breaking the Fall

Johnson, Joyce E.; Veneziano, Teresa; Green, Jacqueline; Howarth, Eileen; Malast, Tracey; Mastro, Kari A.; Moran, Annlouise; Mulligan, Lori A.; Smith, Alicia D.

doi:10.1097/nna.0b013e3182378d53

Cited by 9 publications

(16 citation statements)

References 12 publications

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“…The rate of falls (12.9% vs 12.2%) did not change significantly during the three-month post-intervention data collection period compared to the three-month pre-intervention period. In contrast, significant reductions in falls were reported by Johnson et al [40] with an intervention focussing on falls education for patients and nurses. Across the three-year period which included baseline assessment and intervention, the yearly fall rate reported by Johnson et al [40] in a general hospital ward decreased from 3.5 to 2.3%.…”

Section: Resultsmentioning

confidence: 87%

“…All included studies reported on hospital patients in a variety of settings including acute care [19] [20] [21] [3] [22], geriatric wards [23] [24] [25] [26], surgical units [27], orthopaedic wards or hospital [28] [29] [30], stroke rehabilitation ward [31], post-natal ward [32], psychiatric in-patient ward [33], long term care [34], oncology [35] and general hospital wards [36] [37] [38] [39] [40] [41].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies met the inclusion criteria but did not include sufficient data to be incorporated into the meta-analysis [35] [34] [40]. Each of the three studies incorporated a multifactorial intervention and were conducted using a weaker historical controlled design.…”

Section: Resultsmentioning

confidence: 99%

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The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis

Pavlova

Swinton

Greig

et al. 2022

Preprint

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Objective: The objective of this systematic review and meta-analysis was to evaluate the effectiveness of multicomponent and multifactorial interventions for reducing falls in adult in-patients. Introduction: Falls are the most common cause of accidental injury in hospitals worldwide, resulting in high human and economic costs. In attempts to reduce the number of falls, a wide range of interventions have been employed, often in combination, either as a package (multicomponent) or tailored to the individual (multifactorial). There is a need to synthesise the findings from primary studies and assess which approach may be more effective. Inclusion criteria: The systematic review included studies comprising adult inpatients aged 18 years and over from any hospital setting including elective, non-elective, day-case and secondary care. Randomized controlled trials (RCT), cluster-randomised trials, quasi-experimental controlled trials and historical controlled trials were included that presented sufficient information regarding the rate or number of falls. Methods: This effectiveness review was conducted in accordance with JBI methodology and was guided by an a priori protocol. A comprehensive 3-step search strategy was employed across 14 databases. Screening was conducted by two independent reviewers, and data was extracted using a bespoke data extraction tool designed for this review. Methodological quality was assessed using adapted versions of JBI critical appraisal checklists. Meta-analyses were conducted within a Bayesian framework to interpret results probabilistically and account for covariance in multiple sets of falls data reported in the same study. Effect sizes were calculated by comparing the rate or number of falls in the intervention group compared with usual care. Narrative syntheses were conducted on studies that met the inclusion criteria but did not provide sufficient data for inclusion in meta-analyses. Results: A total of 9,637 records were obtained and following screening 24 studies were included in this review, 21 of which presented sufficient information to be included in meta-analyses. Most studies (n=16) comprised a weaker historical control design with 6 quasi-experimental and only 5 RCT studies. Multifactorial interventions were more common (n=18) than multicomponent (n=6), with the most frequent components including environmental adaptations and assistive aids (75% of studies). Meta-analyses provided evidence that both intervention types were effective at reducing the rate and risk of falls compared to usual care. Evidence was also obtained of greater reductions in rate and risk of falls with multicomponent interventions, however, analyses were potentially confounded by an association between intervention type and study design. Conclusions: Falls interventions routinely employed in hospitals can substantially reduce falls, however, no evidence was obtained in support of tailoring interventions to individual risk factors. Future high-quality RCTs are required that directly compare multicomponent and multifactorial interventions.

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

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The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis

Pavlova

Swinton

Greig

et al. 2022

Preprint

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“…The leaders attribute their collective success to shared governance, open communication, mutual trust and respect, and an unwavering commitment to quality patient care and continuous improvement. They have also leveraged this convergence successfully to achieve significant improvements in nursing outcomes at our hospital, most recently in reducing falls (Johnson et al., ). They established a highly respected brand for nursing at RWUJH—one that survived and thrived through numerous union strikes and has achieved multiple re‐certifications as a Magnet institution.…”

Section: Where Unions and Magnet Meetmentioning

confidence: 99%

Convergence: How Nursing Unions and Magnet are Advancing Nursing

Johnson

Billingsley

2014

Nurs Forum

Self Cite

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“…In the United States falls cause 45% of unintentional trauma-related mortality; this is even higher for women (CDC, 2011;WHOE 2005). Falls in people above the age of 65 years are of special concern since only 50% of these seniors will live more than a year after sustaining a fall (Johnson et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Fall-related injuries in Amsterdam: Frail older women at risk

Harmsen

Egea-Gámez

Garssen

et al. 2016

Journal of Women & Aging

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Unintentional falls are a common cause of injury, especially among older persons. This study evaluates risk factors such as gender and age on morbidity and mortality after unintentional falls. Data were collected retrospectively for patients with a unintentional fall who were presented to the emergency department in 2013. A total of 3,217 patients were included; the majority were female. Patients over 65 years of age had a significant higher mortality and a longer length of hospital stay. Older women are at risk for sustaining a fall-related injury. Female gender is furthermore associated with increased length of stay in the hospital. Prevention should focus especially on these frail patients.

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Breaking the Fall

Abstract: : The data offer a hopeful perspective on the role of nursing engagement in developing a hospital-wide culture of safety and protecting patients from permanent harm caused by fall events.

Cited by 9 publications

References 12 publications

The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis

The effectiveness of multifactorial and multicomponent interventions for the prevention of falls for adults in hospital settings: a systematic review and meta-analysis

Convergence: How Nursing Unions and Magnet are Advancing Nursing

Fall-related injuries in Amsterdam: Frail older women at risk

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