Yoon Lee Kim; Seok Hee Jeong

doi:10.4040/jkan.2015.45.4.469

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Review Article
Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis: Yoon Lee Kim, Seok Hee Jeong; Journal of Korean Academy of Nursing 2015;45(4):469-482.
DOI: https://doi.org/10.4040/jkan.2015.45.4.469
Published online: August 31, 2015

¹Department of Quality Improvement, Jesus Hospital, Jeonju, Korea.

²College of Nursing · Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea.

Address reprint requests to: Jeong, Seok Hee. College of Nursing, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Korea. Tel: +82-63-270-3117, Fax: +82-63-270-3127, awesomeprof@jbnu.ac.kr

• Received: January 28, 2015 • Revised: February 11, 2015 • Accepted: April 11, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
NOTES
REFERENCES
Appendix

Abstract

Purpose
The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients.
Methods
From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g.
Results
Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p <.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p =.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p <.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p <.001) showed the largest effect size among outcome variables.
Conclusion
Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.
Keywords: Nursing interventions; Accidental falls; Prevention and control; Hospitalized patients; Meta-analysis

This manuscript is based on a part of the first author's doctoral dissertation from Chonbuk National University.

REFERENCES

1. Hayes N. Prevention of falls among older patients in the hospital environment. Br J Nurs. 2004;13(15):896–901. Article PubMed
2. Kim YS, Choi-Kwon S. Fall risk factors and fall risk assessment of inpatients. Korean J Adult Nurs. 2013;25(1):74–82.Article PDF
3. Hendrich AL, Bender PS, Nyhuis A. Validation of the Hendrich II fall risk model: A large concurrent case/control study of hospitalized patients. Appl Nurs Res. 2003;16(1):9–21. Article PubMed
4. Oliver D, Papaioannou A, Giangregorio L, Thabane L, Reizgys K, Foster G. A systematic review and meta-analysis of studies using the STRATIFY tool for prediction of falls in hospital patients: How well does it work? Age Ageing. 2008;37(6):621–627. Article PubMed
5. Korea Consumer Agency. Press release: The 'fall accident' takes up most among the medical accidents by improper safety management in the hospital [Internet]. Eumseong-gun, Author. 2006;cited 2014 January 30. Available from: http://www.kca.go.kr/brd/m_32/view.do?seq=749&multi_itm_seq=2
6. Schwendimann R, Bühler H, De Geest S, Milisen K. Characteristics of hospital inpatient falls across clinical departments. Gerontology. 2008;54(6):342–348. Article PubMed PDF
7. Joint Commission International. International patient safety goals [Internet]. Oak Brook, IL, Author. 2011;cited 2014 January 7. Available from: http://www.jointcommissioninternational.org/improve/international-patient-safety-goals/
8. Korea Institute for Healthcare Accreditation. Standard of healthcare accreditation for tertiary hospital: Ver2.0 [Internet]. Seoul, Author. 2014;cited 2014 May 7. Available from: https://www.koiha.or.kr/home/data/data/doList.act?boardtype=05
9. American Nurses Association. NDNQI indicators and reported rates [Internet]. Silver Spring, MD, Author. 2011;cited 2014 January 7. Available from: http://www.nursingquality.org/data.aspx
10. Goodwin VA, Abbott RA, Whear R, Bethel A, Ukoumunne OC, Thompson-Coon J, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: Systematic review and meta-analysis. BMC Geriatr. 2014;14:15Article PubMed PMC PDF
11. Lee DCA, Pritchard E, McDermott F, Haines TP. Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis. Health Educ J. 2014;73(5):530–544. Article PDF
12. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: A systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–2243. Article PubMed
13. Choi M, Hector M. Effectiveness of intervention programs in preventing falls: A systematic review of recent 10 years and meta-analysis. J Am Med Dir Assoc. 2012;13(2):188.e13–188.e21. Article PubMed
14. Coussement J, De Paepe L, Schwendimann R, Denhaerynck K, Dejaeger E, Milisen K. Interventions for preventing falls in acute- and chronic-care hospitals: A systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(1):29–36. Article PubMed
15. Kim CG. Effects on multifactorial fall prevention program of elderly living at home in Korea: Meta-analysis. J Health Med Sci. 2013;2(1):31–38.
16. Park SM. Meta-analysis of the interventions for preventing falls by the elderly in the eight countries: Comparison between aged 70's and 80's. J Korean Gerontol Soc. 2010;30(1):49–63.
17. Son YJ. A systematic review and meta-analysis of the effects of exercise for fall prevention in the elderly [master's thesis]. Suwon, Ajou University. 2013.
18. Park M, Song R. Effects of Tai Chi on fall risk factors: A meta-analysis. J Korean Acad Nurs. 2013;43(3):341–351. Article PubMed
19. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ. 2009;339:b2700Article PubMed PMC
20. Higgins JPT, Green S. In: Cochrane handbook for systematic reviews of interventions: Version 5.1.0 [Internet]. London, UK, The Cochrane Collaboration. 2011;cited 2014 January 7. Available from: www.cochrane-handbook.org.
21. Kim SY, Park JE, Seo HJ, Lee YJ, Son HJ, Jang BH, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency; 2011.
22. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. Article PubMed PMC
23. Hwang SD. Meta-analysis. Seoul: Hakjisa Corp.; 2014.
24. Hedges LV, Olkin I. Statistical methods for meta-analysis. Orlando, FL: Academic Press, Inc.; 1985.
25. Sutton AJ, Duval SJ, Tweedie RL, Abrams KR, Jones DR. Empirical assessment of effect of publication bias on meta-analyses. BMJ. 2000;320(7249):1574–1577.Article PubMed PMC
26. Lee YK. The effect of education for the prevention of falls on the knowledge related to falls, the activity of preventing falls, and fall efficacy among the hospitalized elderly patients [master's thesis]. Seoul, Ewha Womans University. 2013.
27. Chai KJ. A literature review a program of intervention for prevention of falling in the patients with dementia. J Soc Occup Ther Aged Dement. 2010;4(2):27–34.
28. Kim JH, Kim AK. A quality assessment of meta-analyses of nursing in South Korea. J Korean Acad Nurs. 2013;43(6):736–745. Article PubMed
29. Vaapio S, Salminen M, Vahlberg T, Sjösten N, Isoaho R, Aarnio P, et al. Effects of risk-based multifactorial fall prevention on health-related quality of life among the community-dwelling aged: A randomized controlled trial. Health Qual Life Outcomes. 2007;5:20Article PubMed PMC PDF
30. Kim SN. Effects of a multifactorial fall prevention program on physical · psychological function and home environmental hazards in community dwelling low-income elderly. J Korean Gerontol Soc. 2012;32(2):377–395.

Appendix

Appendix 1

Review Paper List

Figure 1

Flow of studies included from database search.

Figure 2

Forest plot of effect size by fall prevention intervention.

Figure 3

Funnel plot of standard error by log odds ratio.

Table 1

Characteristics of Included Studies (N=34)

ED=Education; EN=Environmental; EX=Exercise; RA=Risk assessment; NRCCT=Non-Randomized controlled clinical trial; RCT=Randomized controlled trial.

Table 2

Effect Sizes of Interventions by Intervention Characteristics and Dependent Variables

K=Number of effect size; ES=Effect size; OR=Odds ratio; SE=Standard error; Q=Homogeneity.

Figure & Data

REFERENCES

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Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis

J Korean Acad Nurs. 2015;45(4):469-482. Published online August 31, 2015

DOI: https://doi.org/10.4040/jkan.2015.45.4.469

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Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis

Figure 1 Flow of studies included from database search.

Figure 2 Forest plot of effect size by fall prevention intervention.

Figure 3 Funnel plot of standard error by log odds ratio.

Figure 1

Figure 2

Figure 3

Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis

Table 1

Characteristics of Included Studies (N=34)

ED=Education; EN=Environmental; EX=Exercise; RA=Risk assessment; NRCCT=Non-Randomized controlled clinical trial; RCT=Randomized controlled trial.

Table 2

Effect Sizes of Interventions by Intervention Characteristics and Dependent Variables

K=Number of effect size; ES=Effect size; OR=Odds ratio; SE=Standard error; Q=Homogeneity.

Table 1 Characteristics of Included Studies (N=34)

ED=Education; EN=Environmental; EX=Exercise; RA=Risk assessment; NRCCT=Non-Randomized controlled clinical trial; RCT=Randomized controlled trial.

Table 2 Effect Sizes of Interventions by Intervention Characteristics and Dependent Variables

K=Number of effect size; ES=Effect size; OR=Odds ratio; SE=Standard error; Q=Homogeneity.