J Korean Acad Nurs.  2015 Aug;45(4):469-482. 10.4040/jkan.2015.45.4.469.

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

• Kim YL
• Jeong SH

• KMID: 2164388
• DOI: http://doi.org/10.4040/jkan.2015.45.4.469

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.

Keyword

Nursing interventions; Accidental falls; Prevention and control; Hospitalized patients; Meta-analysis

MeSH Terms

Accidental Falls/*prevention & control
Aged
Databases, Factual
Female
Hospitalization
Humans
Male
Middle Aged
Odds Ratio
Randomized Controlled Trials as Topic
Risk Factors

Figure

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  Figure 1 Flow of studies included from database search.

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

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

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