Evaluation of a nurse-led falls prevention programme versus usual care: a randomized controlled trial

被引:86
作者
Lightbody, E [1 ]
Watkins, C
Leathley, M
Sharma, A
Lye, M
机构
[1] Univ Cent Lancashire, Dept Nursing, Preston PR1 2HE, Lancs, England
[2] Aintree Univ Hosp NHS Fdn Trust, Dept Med Elderly, Liverpool, Merseyside, England
[3] Univ Clin Dept, Liverpool, Merseyside, England
关键词
older people; fall prevention;
D O I
10.1093/ageing/31.3.203
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: to evaluate a nurse-led management plan and care pathway for older people discharged from an Accident and Emergency Department after a fall. Design: randomized controlled trial. Setting: a large teaching hospital. Subjects: 348 consecutive patients aged 65 or over attending the Accident and Emergency Department with a fall. Interventions: we randomized patients to falls nurse intervention or usual care. Within 4 weeks, the intervention group received a home assessment to address easily modifiable risk factors for falls. This included assessments of medication, ECG, blood pressure, cognition, visual acuity, hearing, vestibular dysfunction, balance, mobility, feet and footwear. All patients were given advice and education about general safety in the home. Main outcome measures: Further falls, functional ability, re-attendance at the Accident and Emergency Department and admission to hospital. Results: at 6 months post-Index fall, 36 patients in the intervention group and 39 patients in the control group had had 89 and 145 falls respectively. Although the intervention group had less falls, this was not significant (P>0.05). Similarly, the intervention group had fewer fall-related admissions and bed days (8 and 69 respectively) than the control group (10 and 233 respectively). The intervention group scored significantly higher in indicators of function (P<0.05) and mobility within the community (P<0.02). Conclusions: although the differences were not significant, patients in the intervention group had fewer falls, less hospital attendances and spent less time in hospital. Moreover, patients in the intervention group were more functionally independent at 6 months post-Index fall.
引用
收藏
页码:203 / 210
页数:8
相关论文
共 52 条
[1]   THE PREVALENCE AND CORRELATES OF FEAR OF FALLING IN ELDERLY PERSONS LIVING IN THE COMMUNITY [J].
ARFKEN, CL ;
LACH, HW ;
BIRGE, SJ ;
MILLER, JP .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1994, 84 (04) :565-570
[2]  
Baker S P, 1985, Clin Geriatr Med, V1, P501
[3]   ACCIDENTS AND DRUG TREATMENT IN A PSYCHIATRIC-HOSPITAL [J].
BALLINGER, BR ;
RAMSAY, AC .
BRITISH JOURNAL OF PSYCHIATRY, 1975, 126 (MAY) :462-463
[4]   FALLS BY ELDERLY PEOPLE AT HOME - PREVALENCE AND ASSOCIATED FACTORS [J].
BLAKE, AJ ;
MORGAN, K ;
BENDALL, MJ ;
DALLOSSO, H ;
EBRAHIM, SBJ ;
ARIE, THD ;
FENTEM, PH ;
BASSEY, EJ .
AGE AND AGEING, 1988, 17 (06) :365-372
[5]  
CAMPBELL A J, 1991, Drugs and Aging, V1, P289, DOI 10.2165/00002512-199101040-00005
[6]   THYROID-DISEASE IN THE ELDERLY IN THE COMMUNITY [J].
CAMPBELL, AJ ;
REINKEN, J ;
ALLAN, BC .
AGE AND AGEING, 1981, 10 (01) :47-52
[7]   RISK-FACTORS FOR FALLS IN A COMMUNITY-BASED PROSPECTIVE-STUDY OF PEOPLE 70 YEARS AND OLDER [J].
CAMPBELL, AJ ;
BORRIE, MJ ;
SPEARS, GF .
JOURNALS OF GERONTOLOGY, 1989, 44 (04) :M112-M117
[8]   Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women [J].
Campbell, AJ ;
Robertson, MC ;
Gardner, MM ;
Norton, RN ;
Tilyard, MW ;
Buchner, DM .
BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7115) :1065-1069
[9]   Prevention of falls in the elderly trial (PROFET): a randomised controlled trial [J].
Close, J ;
Ellis, M ;
Hooper, R ;
Glucksman, E ;
Jackson, S ;
Swift, C .
LANCET, 1999, 353 (9147) :93-97
[10]  
*DEP TRAD IND, 1999, AV SLIPS TRIPS BROK