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INTERVENTIONS FOR PREVENTING FALLS IN ACUTE AND CHRONIC CARE HOSPITALS: A SYSTEMATIC REVIEW AND META‐ANALYSIS
Author(s) -
Hadidi Niloufar
Publication year - 2008
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2008.01783.x
Subject(s) - medicine , fall prevention , psychological intervention , meta analysis , systematic review , randomized controlled trial , medline , health care , acute care , poison control , injury prevention , intensive care medicine , nursing , medical emergency , surgery , political science , law , economics , economic growth
choosing to implement the most-effective interventions. The critique considering randomized, controlled trials (RCTs) has to be taken serious when Dr. Oliver argues about the noninclusion of Fonda’s and von RentlenKruse’s studies, which show promising results, although they are not RCTs. Indeed, in this research area, RCTs cannot meet all the criteria of high methodological quality (e.g., no study can completely keep patients, hospital staff, and outcome assessors blind to the study conditions). As mentioned in our review, there is a need for other measures to assess the methodological quality of complex intervention studies like these so as to be able to select studies with the best quality and value for practitioners. These measures must not only consider the best available evidence, but also need to be sustainable over time in often-heterogeneous patient samples within busy hospital units in which fall prevention is often not recognized as a high priority. Furthermore, it appears that there is a need for continuously reinforcing clinicians by training in best-practice interventions and interdisciplinary teamwork to contribute to patient safety. Finally, we would like to remove a source of misunderstanding mentioned in Dr. Oliver’s letter. In the introduction of our review and meta-analysis, some limitations were mentioned about a previous review by Oliver et al., such as failing to list criteria for inclusion, failing to consider the quality of studies, and lack of clarity about what constituted the samples. Indeed, as Dr. Oliver states, these criticisms cannot be given for the more-recent review and meta-analysis by Oliver et al.

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