Impact of a fall prevention programme in acute hospital settings in Singapore

Koh SLS, Hafizah N, Lee JY, Loo YL, Muthu R
Correspondence: Dr Serena Siew Lin Koh, serena.koh.sl@kkh.com.sg

ABSTRACT
Introduction This study aimed to develop a multifaceted strategy using tailored interventions to implement a fall prevention programme, and to achieve a change in fall prevention practices and a reduction in fall incidence at an acute care hospital in Singapore.
Methods A comparative study was conducted at two acute care hospitals (intervention and control) in Singapore. Pre-intervention, post-intervention and six-month follow-up knowledge assessments of 641 nursing staff, and audits of fall rates and fall prevention practices were performed to determine the effectiveness of a multifaceted strategy with targeted interventions in supporting the implementation of a fall prevention programme.
Results The mean post-knowledge test scores at six months were statistically significantly higher (t[516] is -3.3, p-value is less than 0.01) at the intervention hospital (10.3 +/- 2.3) compared to the scores at the control hospital (9.8 +/- 1.8). Increased compliance with the use of fall risk assessment tools was evident in 99.4 percent and 99.3 percent of all patient records at the control and intervention hospitals, respectively. Following the implementation strategy for a fall prevention programme, there was a non-significant reduction in fall rates from 1.44 to 1.09 per 1,000 patient days at the intervention hospital. No reduction in the fall rate was observed at the control hospital.
Conclusion A multifaceted strategy for the implementation of a fall prevention programme was effective in increasing nurses’ knowledge and the use of the fall risk assessment, but did not have a statistically significant impact on a reduction in the fall rate. The increase in nurses’ knowledge and change in nursing practice were important markers of success in terms of fall prevention at the acute hospitals.

Keywords: clinical practice guidelines, fall incidence, fall prevention programme, fall risk assessment
Singapore Med J 2009; 50(4): 425-432