Flooring for Injury Prevention Trial (FLIP)
This study will evaluate the efficacy of novel compliant flooring in reducing injuries due to falls in a long-term care facility, determine the cost effectiveness of this intervention, and assess perceptions about compliant flooring among staff, residents, and families.
The investigators hypothesize that compliant flooring will (1) reduce the incidence of injuries due to falls in long-term care residents; (2) represent an overall cost-savings when material and implementation costs are considered relative to direct and indirect costs associated with injuries due to falls; and (3) be received positively by staff, residents, and their family members.
|Accidental Falls Bone Fracture Traumatic Brain Injury Head Injuries, Closed Nursing Homes||Other: SmartCell flooring Other: Plywood flooring|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
|Official Title:||Randomized Controlled Trial of Compliant Flooring to Reduce Injuries Due to Falls in Older Adults in a Long-Term Care Facility|
- Fall-related injuries [ Time Frame: 4 years ]Moderate and serious injuries that result from falls in resident rooms. Assessed from incident and follow-up reports at participating long-term care facility.
- Falls [ Time Frame: 4 years ]Falls in resident rooms. Assessed from incident reports at participating long-term care facility.
- Fractures [ Time Frame: 4 years ]Fractures in resident rooms. Assessed from incident and follow-up reports at participating long-term care facility.
- Health resource utilization [ Time Frame: 4 years ]Hospital transfers and admissions, emergency room visits, length of hospital stay, physician visits, physiotherapy and occupational therapy visits, nursing visits, diagnostic and lab procedures.
- Musculoskeletal injuries [ Time Frame: 4 years ]Work-related musculoskeletal injuries experienced by staff at participating long-term care facility.
|Study Start Date:||September 2013|
|Estimated Study Completion Date:||September 2017|
|Estimated Primary Completion Date:||September 2017 (Final data collection date for primary outcome measure)|
Experimental: Compliant Flooring (CF)
Other: SmartCell flooring
SmartCell (SATECH Inc., Chehalis, WA, USA) is a continuous rubber surface layer supported by an array of cylindrical rubber columns 14 mm in diameter, and spaced at 19 mm intervals. It has a surface hardness of 50 durometer. It has been reported to provide approximately 35% peak force attenuation during mechanical tests that simulate falls on the hip. It has also been reported to have minimal effect on balance and mobility of older women during activities of daily living. It will be covered with hospital-grade vinyl and will be inspected regularly for maintenance requirements.
Placebo Comparator: Control (CON)
Other: Plywood flooring
Plywood flooring covered with the same hospital-grade vinyl as the SmartCell flooring.
Falls are the number one cause of unintentional injury among older adults in Canada, and are responsible for economic costs in excess of $1 billion CAD annually. In high-risk environments, such as long-term care (LTC) facilities, 60% of residents will experience at least one fall each year. Moreover, approximately 30% of falls in LTC residents result in injury, and 3 to 5% cause fractures.
A promising strategy for reducing the incidence of fall-related injuries in LTC facilities is to decrease the stiffness of the ground surface, and the subsequent force applied to the body parts at impact. Purpose-designed compliant flooring can reduce the force applied to the hip during a fall by up to 35 % (to allow a raw egg to be successfully bounced without cracking). Yet, few LTC facilities have flooring designed to reduce the impact of falls. This study will address this gap.
Resident rooms at a local LTC facility will be randomly assigned to installation of compliant flooring or control (non-compliant) flooring. Following installation, primary and secondary outcomes, including fall-related injuries and falls, will be monitored for 4 years and compared between resident rooms with and without compliant flooring. In addition, health resource utilization and their costs will be compared between resident rooms with and without compliant flooring. Perceptions about compliant flooring will be assessed among staff, residents, and their families.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01618786
|Canada, British Columbia|
|New Vista Care Home|
|Burnaby, British Columbia, Canada, V5E 3Z3|
|Principal Investigator:||Dawn C Mackey, PhD||Simon Fraser University|
|Principal Investigator:||Fabio Feldman, PhD||Fraser Health Authority|
|Principal Investigator:||Andrew C Laing, PhD||University of Waterloo|
|Principal Investigator:||Stephen N Robinovitch, PhD||Simon Fraser University|