Reducing Hospital Falls by Empowering Nurses to Provide Ambulatory Aids

Montefiore Medicine Academic Health System

Status: Terminated

Conditions: Harm Reduction; Accidental Falls

Treatments: Other: Fall Prevention Decision Support

Study type: Interventional

Funder types: Other

Identifiers

NCT03675503

2013-2984

Details and patient eligibility

About

This project proposes to evaluate the potential for nurses to assess if a patient who uses an ambulatory aid at home is fit to use one in the hospital, and the effect that providing ambulatory aids to hospitalized patients will have on reducing hospital falls, with a matched pair cluster-randomized controlled trial.

Hypothesis 1: Of the patients who use an ambulatory aid at home, patients who receive an ambulatory aid in the hospital will have a lower fall rate as compared to patients who do not receive an ambulatory aid in the hospital.

Hypothesis 2: After adequate training, nurses will be able to accurately assess whether or not patients need an ambulatory aid when compared to the gold-standard assessments of physical therapists.

Full description

This research project proposes to study the effectiveness of a specific falls prevention intervention in a high risk population by providing ambulatory aids upon admission to the hospital to patients who previously used one at home after a standardized evaluation by a Registered Nurse. This will be a randomized controlled trial within three hospitals in a large academic medical center.

Primary Objectives:

Specific Aim 1: Evaluate the effectiveness in preventing falls by providing an ambulatory aid to patients who use an ambulatory aid at home, and who are deemed fit to use the device in the hospital by their nurse.

Specific Aim 2: Evaluate the nurses' ability to assess the appropriateness of providing an ambulatory aid, such as a cane or walker, to a patient who uses an assistive device at home.

Enrollment: 900 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• any one determined to be in need of walking aid and
• Can stand up from a seated position independently without assistance
• Can use ambulatory aid at home without assistance/supervision
• Can sit up in bed AND rise to a standing position independently

Exclusion criteria

• Not able to give consent
• Not able to use ambulatory aid independently

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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900 participants in 2 patient groups

Control

No Intervention group

Description:

No change in the standard of care.

Fall Prevention Decision Support

Experimental group

Description:

Nursing assesses patient using the "Assistive Device Checklist" and provides assistive devices to patients, if appropriate. Decision support aimed at preventing hospital falls and empowering nurses.

Treatment:

Other: Fall Prevention Decision Support