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.

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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.