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A volunteer companion-observer intervention reduces falls on an acute aged care ward.

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1
The St George Hospital and University of Technology, Sydney, Australia.

Abstract

PURPOSE:

Falls are the most frequently reported adverse event in hospitalised patients and carry a risk of great harm for the frail elderly. This intervention aimed to prevent high-risk in-patients on an acute aged care ward from falling.

DESIGN/METHODOLOGY/APPROACH:

Patients assessed at high falls risk were accommodated in a room staffed by volunteer companion-observers. The volunteers engaged them in conversation, played cards, opened meals and used the call bell to summon nurses if patients attempted to move from the bed or chair without assistance. Because of occupational health and safety considerations, the volunteers did not assist patients to ambulate.

FINDINGS:

The falls rate in the acute aged care ward decreased by 44 percent (p < 0.000). No patients fell in the observation room when volunteers were present. Relatives of participating in-patients expressed appreciation of the volunteer role, in terms of increased safety and also companionship. Volunteers exercised initiative in determining their pattern of work and developing resources to support their role.

RESEARCH LIMITATIONS/IMPLICATIONS:

Because volunteers are not present around the clock, other strategies are needed to prevent wandering, frequently confused older in-patients from falling during the night.

PRACTICAL IMPLICATIONS:

In a context where frail elderly patients need constant supervision, using volunteers is a reasonable strategy.

ORIGINALITY/VALUE:

This intervention used an inexpensive, human resources-based approach to significantly reduce the incidence of falls in the population at highest risk of falling. The additional benefits to patients in terms of cognitive improvement bear further investigation.

Comment in

  • Patient safety. [Int J Health Care Qual Assur Inc Leadersh Health Serv. 2005]
PMID:
15819122
[Indexed for MEDLINE]
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