Meta-analysis: Multidisciplinary fall prevention strategies in the acute care inpatient population

BACKGROUND: 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. PURPOSE: To examine the available data evaluating multidisciplinary fall prevention strategies in the acute inpatient setting. DATA SOURCES: 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. STUDY SELECTION: 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. DATA EXTRACTION: 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. DATA SYNTHESIS: 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. CONCLUSIONS: 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. Journal of Hospital Medicine 2012; (C) 2012 Society of Hospital Medicine