Reducing Hospital Falls by Empowering Nurses to Provide Ambulatory Aids

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Reducing Hospital Falls by Empowering Nurses to Provide Ambulatory Aids: A Randomized Controlled Trial

Conditions
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Accidental Falls, Harm Reduction

Intervention / Treatment
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* Other: Fall Prevention Decision Support


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>No change in the standard of care. | |
| Experimental: Fall Prevention Decision Support<br>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. | Other: Fall Prevention Decision Support<br>* Decision support used by nurses to appropriately provide ambulatory aids to hospitalized patients in order to reduce hospital falls<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Number Falls | Participants's self reported number of falls will be assess at baseline and 6 months after trial. | Baseline and Six months after study | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Fall Prevention, Hospital Acquired Conditions, Nurse Education, Assistive Devices