Preventing Falls in an Acute Care Setting Through Patient and Family Education

Abstract
Patient falls are of particular interest to hospitals as they are the leading cause of adverse events in this setting and the Center for Medicare and Medicaid no longer reimburses hospitals for care related to serious injury from a patient fall. Evidence based protocols and the literature support multifaceted fall prevention interventions, one of which is falls prevention education to patients and their families. A gap was found in the availability of evidence based falls prevention education.
The study sought to determine if falls and falls with injury rates are decreased in older adults when patients and family support are provided an educational video on falls prevention based on the theory of planned behavior and social support theory. A 36 bed medical unit in a 238 bed community hospital provided a sample of convenience for this quasi-experimental two group design study with a comparison group (N = 100) receiving usual care and education brochure and intervention group (N = 92) receiving usual care, education brochure, and video with teach-back.
The study was unable to reinforce social support due to the small numbers of family viewing the video (N = 7). No statistical difference between groups was found based on rates of falls per 1000 patient days, 2(1, N = 192) = 1.86, p = .270 due to the small number of falls. However, a statistically significant difference was demonstrated between groups in the proportion of patients receiving any falls education intervention based on the study phase, 2(1, N = 192) =0.20, p < .001 and exceeded Cohen’s (1992) convention for medium effect size. This statistical difference between groups for fidelity of education intervention supports clinically significant findings when comparing the frequency of fall rates between groups (Phase 1 = 6.01 vs. Phase 2 = 0.0). Interestingly, 70% of intervention participants viewed a falls education video and 94% of these participants received follow up by way of teach-back by the Registered Nurse. The results of this study provide clinically significant support for previous study’s findings for the use of multimedia education and teach-back.
Keywords: falls, education, hospital, acute care, older, education, and planned behavior.