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Open Access Study protocol

Predicting the risk of falling – efficacy of a risk assessment tool compared to nurses' judgement: a cluster-randomised controlled trial [ISRCTN37794278]

Gabriele Meyer1*, Sascha Köpke1, Ralf Bender2 and Ingrid Mühlhauser1

Author Affiliations

1 University of Hamburg, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146 Hamburg, Germany

2 Institute for Quality and Economic Efficiency in Health Care, Dillenburger Straße 27, D-51105 Köln, Germany

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BMC Geriatrics 2005, 5:14  doi:10.1186/1471-2318-5-14

Published: 10 November 2005

Abstract

Background

Older people living in nursing homes are at high risk of falling because of their general frailty and multiple pathologies. Prediction of falls might lead to an efficient allocation of preventive measures. Although several tools to assess the risk of falling have been developed, their impact on clinically relevant endpoints has never been investigated. The present study will evaluate the clinical efficacy and consequences of different fall risk assessment strategies.

Study design

Cluster-randomised controlled trial with nursing home clusters randomised either to the use of a standard fall risk assessment tool alongside nurses' clinical judgement or to nurses' clinical judgement alone. Standard care of all clusters will be optimised by structured education on best evidence strategies to prevent falls and fall related injuries. 54 nursing home clusters including 1,080 residents will be recruited. Residents must be ≥ 70 years, not bedridden, and living in the nursing home for more than three months. The primary endpoint is the number of participants with at least one fall at 12 months. Secondary outcome measures are the number of falls, clinical consequences including side effects of the two risk assessment strategies. Other measures are fall related injuries, hospital admissions and consultations with a physician, and costs.