{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:37:47Z","timestamp":1778024267178,"version":"3.51.4"},"reference-count":26,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2011,5,1]]},"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background and aims<\/jats:title>\n                  <jats:p>In-hospital fall-related injuries are a source of personal harm, preventable hospitalisation costs, and access block through increased length of stay. Despite increased fall prevention awareness and activity over the last decade, rates of reported fall-related fractures in hospitals appear not to have decreased. This cluster randomised controlled trial (RCT) aims to determine the efficacy of the 6-PACK programme for preventing fall-related injuries, and its generalisability to other acute hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>24 acute medical and surgical wards from six to eight hospitals throughout Australia will be recruited for the study. Wards will be matched by type and fall-related injury rates, then randomly allocated to the 6-PACK intervention (12 wards) or usual care control group (12 wards). The 6-PACK programme includes a nine-item fall risk assessment and six nursing interventions: \u2018falls alert\u2019 sign; supervision of patients in the bathroom; ensuring patient's walking aids are within reach; establishment of a toileting regime; use of a low-low bed; and use of bed\/chair alarm. Intervention wards will be supported by a structured implementation strategy. The primary outcomes are fall and fall-related injury rates 12\u2005months following 6-PACK implementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This study will involve approximately 16\u2008000 patients, and as such is planned to be the largest hospital fall prevention RCT to be undertaken and the first to be powered for the important outcome of fall-related injuries. If effective, there is potential to implement the programme widely as part of daily patient care in acute hospital wards where fall-related injuries are a problem.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000332921).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/injuryprev-2011-040074","type":"journal-article","created":{"date-parts":[[2011,6,8]],"date-time":"2011-06-08T23:48:44Z","timestamp":1307576924000},"page":"e5-e5","source":"Crossref","is-referenced-by-count":20,"title":["The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomised controlled trial: Figure 1"],"prefix":"10.1136","volume":"17","author":[{"given":"Anna","family":"Barker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Brand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Haines","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandy","family":"Brauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Jolley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mari","family":"Botti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Cumming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia M","family":"Livingston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathie","family":"Sherrington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silva","family":"Zavarsek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata","family":"Morello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannette","family":"Kamar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2011,6,8]]},"reference":[{"key":"2025092603185042000_17.4.e5.1","doi-asserted-by":"crossref","unstructured":"Davis JC Robertson MC Comans T . Guidelines for conducting and reporting economic evaluation of fall prevention strategies. Osteoporos Int. Published Online First: 23 November 2010. doi:10.1007\/s00198-010-1482-0.","DOI":"10.1007\/s00198-010-1482-0"},{"key":"2025092603185042000_17.4.e5.2","doi-asserted-by":"publisher","DOI":"10.1071\/AH070471"},{"key":"2025092603185042000_17.4.e5.3","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1111\/j.1532-5415.2007.01371.x","article-title":"Falls in a hospital setting","volume":"55","author":"Briggs","year":"2007","journal-title":"J Am Geriatr Soc"},{"key":"2025092603185042000_17.4.e5.4","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.2007.025676"},{"key":"2025092603185042000_17.4.e5.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39499.546030.BE"},{"key":"2025092603185042000_17.4.e5.6","unstructured":"Lord SR Sherrington C Menz HB . Falls in Older People: Risk Factors and Strategies for Prevention. Cambridge, UK; New York: Cambridge University Press, 2001."},{"key":"2025092603185042000_17.4.e5.7","unstructured":"Tideiksaar R Tideiksaar R . Falls in Older People: Prevention and Management. 3rd edn. Baltimore, MD: Health Professions Press, 2002."},{"key":"2025092603185042000_17.4.e5.8","doi-asserted-by":"crossref","unstructured":"Brand CA Sundararajan V . A 10-year cohort study of the burden and risk of in-hospital falls and fractures using routinely collected hospital data. Qual Saf Health Care 2010 Dec;19(6):e51.","DOI":"10.1136\/qshc.2009.038273"},{"key":"2025092603185042000_17.4.e5.9","first-page":"25","article-title":"Current costing models: are they suitable for allocating health resources? The example of fall injury prevention in Australia","volume":"37","author":"Moller","year":"2005","journal-title":"Accid Anal Prev"},{"key":"2025092603185042000_17.4.e5.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.676"},{"key":"2025092603185042000_17.4.e5.11","unstructured":"Australian commission on safety and quality in health care. Preventing Falls and Harm From Falls in Older People: Best Practice Gudielines for Australian Hospitals. Sydney, Australia; 2009."},{"key":"2025092603185042000_17.4.e5.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2010.06.005"},{"key":"2025092603185042000_17.4.e5.13","doi-asserted-by":"crossref","unstructured":"Cameron ID Murray GR Gillespie LD . Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev 2010;(1):CD005465.","DOI":"10.1002\/14651858.CD005465.pub2"},{"key":"2025092603185042000_17.4.e5.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.1567"},{"key":"2025092603185042000_17.4.e5.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02856.x"},{"key":"2025092603185042000_17.4.e5.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02735.x"},{"key":"2025092603185042000_17.4.e5.17","unstructured":"Barker A Kamar J Hill K . Reducing serious fall-related injuries in acute hospitals: are low-low beds a critical success factor? J Adv Nurs Under review."},{"key":"2025092603185042000_17.4.e5.18","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.444"},{"key":"2025092603185042000_17.4.e5.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2010.05503.x"},{"key":"2025092603185042000_17.4.e5.20","doi-asserted-by":"publisher","DOI":"10.1097\/NNA.0b013e3181a7788a"},{"key":"2025092603185042000_17.4.e5.21","unstructured":"Institute for Healthcare Improvement. What is a Bundle? Improvement stories [Serial on the Internet]. 2006. http:\/\/www.ihi.org\/IHI\/Topics\/CriticalCare\/IntensiveCare\/ImprovementStories\/WhatIsaBundle.htm."},{"key":"2025092603185042000_17.4.e5.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2010.05503.x"},{"key":"2025092603185042000_17.4.e5.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02142.x"},{"key":"2025092603185042000_17.4.e5.24","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afi218"},{"key":"2025092603185042000_17.4.e5.25","first-page":"73","article-title":"The safety of safety research: the case of patient fall research","volume":"38","author":"Morse","year":"2006","journal-title":"Can J Nurs Res"},{"key":"2025092603185042000_17.4.e5.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.654"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/injuryprev-2011-040074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:18:58Z","timestamp":1758881938000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/injuryprev-2011-040074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,6,8]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2011,7,25]]},"published-print":{"date-parts":[[2011,8]]}},"alternative-id":["10.1136\/injuryprev-2011-040074"],"URL":"https:\/\/doi.org\/10.1136\/injuryprev-2011-040074","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,6,8]]}}}