Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
J Hosp Med. 2012 Jul-Aug;7(6):497-503. doi: 10.1002/jhm.1917. Epub 2012 Feb 27.
Inpatient falls are common adverse events that lead to inpatient injury, increased length of stay, healthcare costs, litigation, and are a focus of patient safety and healthcare quality. Fall prevention methods are currently evolving to address the problem.
To examine the available data evaluating multidisciplinary fall prevention strategies in the acute inpatient setting.
A complete literature search of MEDLINE, CINAHL, EMBASE and the Cochrane Library through December 2011 was used. The bibliographies of all systematic reviews and meta-analyses were hand searched.
Only primary research studies relating to acute care inpatient hospital multidisciplinary fall prevention were included. Selected papers were assessed for quality by 2 authors using a 20-point scale previously used in the fall literature.
Each selected study was carefully hand searched by 2 authors for the purposes of data extraction. Study results, in fall rate per 1000-patient days, and the characteristics of the interventions used were extracted for analysis.
Effect sizes (odds ratios) and 95% confidence intervals were derived for individual studies and then combined across research reports using a random-effects meta-analysis.
Fall prevention strategies have a significant but small effect on fall rates despite the use of complex, multidisciplinary interventions. Additional randomized trials are needed to examine the possible benefits of multidisciplinary fall prevention strategies in the acute inpatient setting.
住院患者跌倒属于常见的不良事件，可导致患者受伤、住院时间延长、增加医疗成本、引起法律诉讼，是患者安全和医疗质量关注的焦点。目前，正在采用各种方法预防跌倒。
分析评估急性住院环境下多学科预防跌倒策略的现有数据。
通过 2011 年 12 月前的 MEDLINE、CINAHL、EMBASE 和 Cochrane 图书馆，进行全面的文献检索。手工检索所有系统评价和荟萃分析的参考文献。
仅纳入与急性护理住院患者多学科预防跌倒相关的原始研究。使用先前在跌倒文献中使用的 20 分制，由 2 位作者对入选文献进行质量评估。
由 2 位作者对每篇入选文献进行仔细的手工检索，以提取数据。提取研究结果（每千名患者天的跌倒率）和干预措施特点，用于分析。
对单个研究计算效应量（比值比）和 95%可信区间，然后使用随机效应荟萃分析综合研究报告中的结果。
尽管采用了复杂的多学科干预措施，但预防跌倒策略对跌倒率的影响仅具有统计学意义但很小。需要进一步的随机试验来检验急性住院环境下多学科预防跌倒策略的可能益处。
