Fall prevention in residential care: a cluster, randomized, controlled trial.

OBJECTIVES

To establish the effectiveness of a fall-prevention program in reducing falls and injurious falls in older residential care residents.

DESIGN

Cluster, randomized, controlled trial.

SETTING

Fourteen randomly selected residential care homes in Auckland, New Zealand.

PARTICIPANTS

All older residents (n=628, 95% participation rate).

INTERVENTION

Residential care staff, using existing resources, implemented systematic individualized fall-risk management for all residents using a fall-risk assessment tool, high-risk logo, and strategies to address identified risks.

MEASUREMENTS

Number of residents sustaining a fall, falls, and injurious-falls incidence rates.

RESULTS

During 12 months of follow-up, 103 (43%) residents in the control group and 173 (56%) residents in the intervention group fell (P<.018). There was a significantly higher incidence rate of falls in intervention homes than in control homes (incident rate ratio=1.34, 95% confidence interval=1.06-1.72) during the intervention period after adjusting for dependency level (type of home), baseline fall rate, and clustering. There was no difference in the injurious fall incidence rate or incidence of serious injuries.

CONCLUSION

This fall-prevention intervention did not reduce falls or injury from falls. Low-intensity intervention may be worse than usual care.