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Kim and Jeong: Effects of Nursing Interventions for Fall Prevention in Hospitalized Patients: A Meta-analysis
Review Article

Journal of Korean Academy of Nursing 2015; 45(4): 469-482.

Published online: 31 August 2015

DOI: https://doi.org/10.4040/jkan.2015.45.4.469

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

Yoon Lee Kim1, Seok Hee Jeong2

1Department of Quality Improvement, Jesus Hospital, Jeonju, Korea.

2College of Nursing · Research Institute of Nursing Science, Chonbuk National University, Jeonju, Korea.

Address reprint requests to: Jeong, Seok Hee. College of Nursing, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Korea. Tel: +82-63-270-3117, Fax: +82-63-270-3127, awesomeprof@jbnu.ac.kr

Received 28 January 2015       Revised 11 February 2015       Accepted 11 April 2015

© 2015 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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.

Keywords: Nursing interventions, Accidental falls, Prevention and control, Hospitalized patients, Meta-analysis

Figures and Tables

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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Table 1

Characteristics of Included Studies (N=34)

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ED=Education; EN=Environmental; EX=Exercise; RA=Risk assessment; NRCCT=Non-Randomized controlled clinical trial; RCT=Randomized controlled trial.

Table 2

Effect Sizes of Interventions by Intervention Characteristics and Dependent Variables

jkan-45-469-i002

K=Number of effect size; ES=Effect size; OR=Odds ratio; SE=Standard error; Q=Homogeneity.

Notes

This manuscript is based on a part of the first author's doctoral dissertation from Chonbuk National University.

Appendix

Appendix 1

Review Paper List

jkan-45-469-a001

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