Falls Aren't Us: Outcomes of Randomized Environmental Fall Prevention Room Intervention Study on Incidence of Falls in the Hospitalized Elderly Patients

Wednesday, 15 July 2009: 3:45 PM

Huberta-Corazon (Bette) Thiam Cozart, MS, RN
College of Nursing, Prairie View A & M University, Houston, TX
Pamela Willson, RN, PhD, FNP, BC
Elsevier Review and Testing, Elsevier Publishing, Houston, TX
Karen Stonecypher, MSN, RN
Clinical Practice Office, Michael E. DeBakey VA Medical Center, Houston, TX
Aixa Lebron-Marquez, BSN, RN
Neurology & Rehabilitation Line, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX

Learning Objective 1: describe results of a fall prevention study using environmental devices in hospitalized elderly for global management of accidental falls.

Learning Objective 2: apply in practice a primary prevention intervention labeled as Fall Prevention Rooms (FPR) to reduce accidental falls worldwide.

Purpose: The aim of this study was to measure the effectiveness of an environmental fall primary prevention intervention, a Fall Prevention Room (FPR) among hospitalized patients, aged 50 or older admitted in neurology/rehabilitation unit, who scored 45 and greater on the Morse Fall Scale, and thus, were considered at high risk for falling and met eligibility criteria. FPR were hospital rooms equipped with various fall prevention devices including, shower mats, non-skid socks, non-skid slippers, floor cushions, hipsters, and bed alarms.  Methods: Two-group prospective, block-randomized design was used to evaluate FPR effectiveness in reducing in-patient falls for seven-day hospitalization from June to August 2008. Sixty-four participants were randomly assigned to either FPR or regular rooms. Daily follow-up assessments were done for seven days. Instruments used were Equipment Safety Checklist, Fall Incident Reports, and patient self-report of falls. Results:  Participants mean age was 64years (SD = 8.94) and primarily male gender (97 %). Sample was made up of 56 % (n = 36) white, 38 % (n = 24) African-American, and 6 % (n = 4) Hispanic. One-sample chi-square test was conducted to assess whether the proportion of fallers was less in the FPR group. Test results were significant, χ2 (Df - 1, N = 64) = 49.00, p < 0.001. Likewise, of clinical importance was the four fallers (6.3 %; n = 4); three fallers were assigned to regular care, and only one faller was assigned to FPR. Falls happened during late afternoons, while performing transfer, hygiene, and toileting activities and occurred on the second, third, fourth, and seventh days of hospitalization. Conclusion: FPR may facilitate achievement of the ninth goal of the Joint Commission of Accreditation of Healthcare Organizations namely, to “reduce the risk of patient harm resulting from falls” and achievement of Healthy People 2010 15th goal namely, to “reduce death from falls”.