Evidence Table 1

Reviews Examining Fall-Prevention Interventions in the Community

SourceSafety Issue Related to Clinical PracticeDesign Type*Study Design, Study Outcome Measure(s)Study Setting & Study PopulationStudy InterventionKey Finding(s)
Weigand 200193Fall and injury prevention in the communityLiterature ReviewDesign: Review
Outcomes: Fall rates
Setting: Community

Population: Emergency patients
Assessment of fallers & targeted interventionsFalls: No definitive evidence to support ED assessment followed by targeted interventions is effective for preventing falls. More research required.
Cumming 2002100Fall and injury prevention in the communityLiterature ReviewDesign: Review
Outcomes: Fall rates
Setting: Community

Population: Older adults
Multiple interventions; 21 trials reviewedFalls:
  • Exercise programs most promising.
  • Reduction of antipsychotic medications should be considered.
  • No definitive prevention strategy.
Gillespie 2003104Fall and injury prevention in the communityMeta-analysisDesign: Systematic Review
Outcomes: Fall rates
Setting: Community
Population: 21,668 people
Multiple interventions; 62 trials reviewedFalls: Multimodal, interdisciplinary prevention programs are most successful.
Risk Assessment: Need more accurate risk assessment instruments.
Chang 200499Fall and injury prevention in the communityMeta-analysisDesign: Review
Outcomes: Fall rates
Setting: Community

Population: Older adults
Multiple interventions; 40 trials reviewedFalls: Multimodal assessments with targeted intervention reduced risk of falls by 37 percent, and exercise interventions reduced fall risk by 14 percent.
Hill-Westmoreland 200538Fall and injury prevention in the communityMeta-analysisDesign: Meta-analysis
Outcomes: Fall rates
Setting: Community
Population: Older adults in long-term care setting
Multiple interventions; 12 studies reviewedFalls: Decrease in fall rates when individualized management added to exercise interventions.
Stevenson 2005135Fall and injury prevention in the communitySystematic ReviewDesign: Systematic review
Outcomes: Fracture, vertebral and nonvertebral
Setting: Community
Population: Older women at risk for fracture
Review of calcium, vitamin D, and bisphosphonatesFractures:
  • Calcium, with or without vitamin D, reduces fractures in patients with high risk for fracture.
  • Calcium with vitamin D can prevent fractures in women not at risk for fractures.
Shekele 200311Fall and injury prevention in the communityMeta-analysisDesign: Meta-analysis
Outcomes: Fall and injury rates
Setting: Community

Population: Medicare recipients
Mulriple interventionsFalls:
Multifactorial fall prevention programs decrease fall rates
*

Study Design Type: (1) Meta-analysis, (2) Randomized controlled trials, (3) Nonrandomized trials, (4) Cross-sectional studies, (5) Case control studies, (6) Pretest and post-test (before and after) studies, (7) Time series studies, (8) Noncomparative studies, (9) Retrospective cohort studies, (10) Prospective cohort studies, (11) Systematic literature reviews, (12) Literature reviews, nonsystematic/narrative, (13) Quality-improvement projects/research, (14) Changing-practice projects/research, (15) Case series, (16) Consensus reports, (17) Published guidelines, (18) Unpublished research, reviews, etc.

Study Design Type: (1) Meta-analysis, (2) Randomized controlled trials, (3) Nonrandomized trials, (4) Cross-sectional studies, (5) Case control studies, (6) Pretest and post-test (before and after) studies, (7) Time series studies, (8) Noncomparative studies, (9) Retrospective cohort studies, (10) Prospective cohort studies, (11) Systematic literature reviews, (12) Literature reviews, nonsystematic/narrative, (13) Quality-improvement projects/research, (14) Changing-practice projects/research, (15) Case series, (16) Consensus reports, (17) Published guidelines, (18) Unpublished research, reviews, etc.

From: Chapter 10, Fall and Injury Prevention

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

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