Accidental Falls Clinical Trial
Official title:
The Effects of a Fall Prevention Program on Falls, Patient Safety Culture and Patient-perceived Safety. Two Cross-sectional Studies in Two Orthopedic Departments
The incidence of fractures in Norway is among the highest in the world, and falls are the
sixth major contributor to years lived with disability. In elderly, a large part of 900
deaths from unintentional injuries per 100000 inhabitants per year, are due to falls and
fractures. Fractures, especially hip fractures among the elderly, often result in pain,
ailments, and reduced quality of life. In Norway, 11 % of all reports from the specialized
health services were incidents related to falls. Worldwide, falls are among the most commonly
reported adverse events in hospitals with prevalence rates in the order of 10 per 1000
patient days or 5-15 % of the patients, and are associated with both minor and major
injuries. The results of preventive measures are conflicting.
In January 2011, the Norwegian health minister launched a national patient safety campaign
called "In Safe hands". The campaign had three aims: 1) Reduce patient related adverse
events, 2) Build sustainable systems and structures for patient safety, and 3) Improve the
patient safety culture. Hospitals and primary care units were invited to participate in 16
specific and measurable areas for improvement. One out of four orthopedic departments at Møre
og Romsdal Hospital Trust, Norway participated actively in a fall prevention program.
This study compares the changes in fall rates, the employees' perceived patient safety
culture and the patient experienced safety before and after implementation of the fall
prevention program at the orthopedic department in one hospital in the Møre & Romsdal
Hospital Trust, and at the same time points i another hospital in the same Trust but not
having implemented the program.
The interventions are multifaceted and include short and long-term activities to prevent falls. Fall screening, performed with the Norwegian version of the risk assessment tool for falls in elderly "STRATIFY (score 0 - 5), is the main tool. In patients with a score of 2 or more, a comprehensive individual plan for fall prevention has been worked out for each patient with risk of fall, documented in the medical records, and communicated to the staff responsible for the patient. The plan includes practical initiatives like adjusting the beds, proper illumination, instructions not to leave the bed unaided, and appropriate shoes. There are also long-term measures like the treatment of underlying diseases, changes in medication associated with risk of fall, physical training, and healthier dietary habits. During the intervention, the process is measured and reported to the national campaign. The national intervention was designed for use in hospitals, care facilities and patients living at home. Most of the proposed activities aim at preventing falls in a long time perspective. ;
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