Evidence map›Paper›PMID 26813674›Full record

Trial reportBMJ (Clinical research ed.)2016

6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial.

Anna L Barker, Renata T Morello, Rory Wolfe, Caroline A Brand, Terry P Haines, Keith D Hill, Sandra G Brauer, Mari Botti, Robert G Cumming, Patricia M Livingston and 4 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 9 pooled it
15.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 9 syntheses or guidelines pooled it, 150 citations in OpenAlex.

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  17. Nurse-led fall prevention programs in acute care settings: An integrative review.International journal of nursing studies advances · 2025
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 1 country.

Anna L BarkerDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia anna.barker@monash.edu.
Renata T MorelloDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Rory WolfeDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Caroline A BrandDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Terry P HainesPhysiotherapy Department, Monash University, Allied Health Research Unit, Monash Health, Kingston Centre, Cheltenham, VIC 3195, Australia.
Keith D HillSchool of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia.
Sandra G BrauerDivision of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD 4072, Australia.
Mari BottiSchool of Nursing and Midwifery, Deakin University, Burwood, VIC 3125, Australia.
Robert G CummingSchool of Public Health, University of Sydney, Sydney, NSW 2006, Australia.
Patricia M LivingstonSchool of Nursing and Midwifery, Deakin University, Burwood, VIC 3125, Australia.
Catherine SherringtonGeorge Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
Silva ZavarsekCentre for Health Economics, Monash Business School, Monash University, Clayton, VIC 3800, Australia.
Richard I LindleyGeorge Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
Jeannette KamarNorthern Hospital, Northern Health, Epping, VIC 3076, Australia.
Monash University · AUDeakin University · AUUniversity of Sydney · AUCurtin University · AUNorthern Hospital · AUThe George Institute for Global Health · AUUniversity of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards.

designCluster randomised controlled trial.

settingSix Australian hospitals.

participantsAll patients admitted to 24 acute wards during the trial period.

interventionsParticipating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm.

main outcome measuresThe co-primary outcomes were falls and fall injuries per 1000 occupied bed days.

resultsDuring the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; P<0.001). In all, 1831 falls and 613 fall injuries occurred, and the rates of falls (incidence rate ratio 1.04, 0.78 to 1.37; P=0.796) and fall injuries (0.96, 0.72 to 1.27; P=0.766) were similar in intervention and control wards.

conclusionsPositive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12611000332921.

Indexed as

Accidental FallsAgedAttitude of Health PersonnelAustraliaClinical ProtocolsFemaleHospitalizationHospitalsHumansMaleRisk AssessmentWounds and Injuries

Identifiers

PMID26813674
PMCPMC4727091
OpenAlexW2259441680

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.