Hignett and Masud (2006) also examined the literature for equipment used to prevent falls. Besides looking at flooring and bed alarms, they also looked at the efficacy of nonslip footwear, staffing levels, and patient assessment tools.
Footwear:
They found that in 20% of falls, the residents had improper footwear (Mion et al., 1989). In looking at solutions to prevent falls due to slipping, Staal and colleagues (2004) looked at solutions outside the health-care industry, such as commercial fishing and restaurant industries. They examined positive grip shoe covers over regular footwear and recorded no slipping incidents during the trial and suggested that these positive grip shoes might be especially useful for moving and handling activities in shower areas.
Environmental cues and staffing levels:
They also examined the impact of other methods that can indirectly prevent falls, specifically, environmental cues and staffing levels. Coltharp and colleagues (1996) suggested that the phenomenon of wandering was a natural process of searching for security and familiarity. They advocated the use of environmental cues such as visual barriers, cues, and a reduction in background noise as methods for dealing with wandering. Dunton and colleagues (2004) reported that higher fall rates were associated with fewer nursing hours per nursing day and a lower percentage of registered nurses in the care units.
Assistive devices:
Assistive devices such as canes, walkers, safety poles or bathroom grab bars are also recommended to reduce the risk of falling. Although empirical research to prove their effectiveness is lacking, a literature review by the Veterans Affairs Canada Falls Prevention Initiative (2001) found that they can play an important role in increasing seniors’ confidence and mobility and encouraging independence.
In conclusion, among the five interventions reviewed by Agostini et al. (2001), there is only sufficient evidence on the effectiveness of hip protectors and the negative consequences of physical restraints. There is insufficient evidence on the effectiveness of identification bracelets, bed alarms, and special flooring. As well, Hignett and Masud (2006) concluded that even though f ootwear, flooring, lighting and staffing levels were all shown to have an association with falls incidents, no research was found to evaluate the benefit of implementing these recommendations to address falls.
Additional Interventions:
Todd and Skelton (2004) came up with a list of other multi-factorial interventions that have evidence to support the prevention of falls and fall injuries in long term care settings:
For more information on fall management options that are currently available, visit the Technology for Long term Care - Fall Management website at: http://www.techforltc.org/ltc.cfm?pageid=154&CareIssue=1
The site includes information on: