Showing papers by "René Schwendimann published in 2008"
TL;DR: To determine the characteristics and the effectiveness of hospital fall prevention programs, a large number of patients with a history of hospital falls are surveyed over a two-year period to assess the impact of these programs.
Abstract: OBJECTIVES: To determine the characteristics and the effectiveness of hospital fall prevention programs. DESIGN: Systematic literature search of multiple databases (Medline, Cinahl, Precinahl, Invert, the Cochrane Library) and of the reference list of each identified publication. SETTING: Inclusion of prospective controlled-design studies reporting the effectiveness of fall prevention programs in hospitals. PARTICIPANTS: Two reviewers. MEASUREMENTS: The methodological qualities of the studies were assessed based on 10 criteria. For the meta-analysis, the relative risk of a fall per occupied bed day (RR(fall)) and the relative risk of being a faller (RR(faller)) were calculated. RESULTS: Eight studies met the inclusion criteria, of which four studies tested multifactorial interventions. Although these studies took place in hospitals, most were conducted on long-stay (mean length of stay (LOS) <1.5 years) and rehabilitation units (mean LOS 36.9 days). For analysis of the number of falls, one unifactorial and two multifactorial studies showed a significant reduction of 30% to 49% in the intervention group, with the greatest effect obtained in the unifactorial study that assessed a pharmacological intervention. The pooled RR(fall) for the four multifactorial studies became nonsignificant after adjustment for clustering (RR(fall)=0.82, 95% confidence interval (CI)=0.65-1.03). No studies reported a significant reduction, either single or pooled, in the number of fallers in the intervention group (pooled RR(faller)-0.87, 95% CI=0.70-1.08). CONCLUSION: This meta-analysis found no conclusive evidence that hospital fall prevention programs can reduce the number of falls or fallers, although more studies are needed to confirm the tendency observed in the analysis of individual studies that targeting a patient's most important risk factors for falls actively helps in reducing the number of falls. These interventions seem to be useful only on long-stay care units.
232 citations
TL;DR: In the hospital studied, inpatient falls are significantly more common in departments of geriatrics and internal medicine than in surgical departments, probably due to differences in patient characteristics.
Abstract: Background: Hospital inpatient falls are common and may lead to injuries and prolonged hospitalization. Although hospital studies have reported overall fall rates and injuries assoc
167 citations
TL;DR: I have no criticisms of the JAGS study, but readers should be cautious in taking home to their own institutions the message that fall prevention programs in hospital do not work after all.
Abstract: Second, it stated that that it ‘‘failed to consider the quality of studies.’’ (Actually, the Downs and Black quality score was explicitly employed and used to order the studies in forest plots.) Third, it stated that it failed to make clear ‘‘what constituted the samples.’’ (The characteristics of study populations are clearly set out in the ‘‘Web extra’’ tables.) A more valid potential criticism would be of the deliberate decision to include and pool studies that were not RCTs. To exclude such studies might have led to the rejection of useful sources of evidence for practice in a field in which ‘‘criterion standard’’ RCTs are hard to perform. I have no such criticisms of the JAGS study, which also incorporated two studies reported after the census date of the original study, but readers should be cautious in taking home to their own institutions the message that fall prevention programs in hospital do not work after all, because:
1 citations