WA researchers find formula for fewer falls

Patient practising walking with the help of a physiotherapist
A Fremantle Hospital physiotherapist helps guide a patient practising to walk
April 10, 2015

WA Health research has come up with a winning formula for reducing the rate of inpatient falls, an extremely costly and common problem for hospitals worldwide.

The research, which involved Fremantle Hospital staff and patients, found that individualised patient education, when combined with staff training and patient feedback, was effective in reducing the rate of falls among older patients and the incidence of injurious falls among these patients.

WA Health geriatrician Nick Waldron was principal investigator on the project which was led by Dr Anne-Marie Hill from the University of Notre Dame Australia.
Details of trial are published in the latest issue of The Lancet.

Dr Waldron described the trial as the first of its kind in the world to report a significant reduction in the rate of injurious falls.

Across the eight WA hospital rehabilitation units over which the trial was conducted, including Fremantle Hospital, the rate of falls among older patients declined about 40 per cent while the rate of injurious falls almost halved, dropping from 4.7 to 2.6 falls per 1000 patient days.

“A fall can have a devastating impact on an older person,” Dr Waldron said. 

“Close to a third of falls will cause a physical injury that can lead to a loss of independent living and a fear of falling. 

"A small percentage of older people may even die as a result of injuries from a fall so the findings of our research are really exciting.” 

Dr Waldron revealed that a surprising but welcome finding of the study was that all patients on the ward benefited from the two-pronged intervention, even those with impaired cognition (including dementia) who did not receive the education. 

“The key to our success seems to be in the approach we’ve taken to heightening falls prevention awareness among both patients and staff, effectively creating a ward-wide benefit,” he said.

Potential savings from the approach are also significant with an estimated $4 saving for every dollar invested in the initiative.

The research undertaken by Dr Waldron and his research colleagues was funded using a State Health Research Advisory Council Research Translation Project grant.

These SHRAC RTP program funds research projects that provide direct benefit to the WA community.

Western Australia’s chief medical officer Gary Geelhoed said the work of Dr Waldron and his colleagues on the project highlighted the enormous and immediate benefit that research undertaken by WA researchers and clinicians was having on the community.

“The findings of this project will not only lead to significant cost savings for Western Australia’s public health system but will spare many Western Australians the terrible consequences that can follow a fall,” Professor Geelhoed said.

Patients participating in the falls prevention initiative were shown DVD and given a workbook. A physiotherapist would then follow up with the patient, giving them the opportunity to clarify any issues and develop their own “safety plan” as well as raise any concerns that could be fed back to other ward staff.