OBJECTIVE: To test the effectiveness of using a full-time project nurse to 
assist residential aged care facilities in using evidence-based approaches to 
falls injury prevention.
DESIGN, SETTING AND PARTICIPANTS: Cluster randomised controlled trial involving 
5391 residents in 88 aged care facilities in the Hunter and Lower Mid North 
Coast areas of New South Wales. Residents were followed for 545 days or until 
death or discharge. Data were collected from July 2005 to June 2007.
INTERVENTION: Employment of a project nurse to encourage best-practice falls 
injury prevention strategies during the 17-month intervention period.
MAIN OUTCOME MEASURES: Monthly data about falls, falls injury and falls injury 
prevention programs; audit of hospitalisation for fractured neck of femur.
RESULTS: Despite significant increases in the provision of hip protectors and 
use of vitamin D supplementation in both intervention and control facilities, 
there was no difference in the number of falls or falls injuries between the 
intervention and control groups, nor a reduction in falls overall. There was 
also no difference between the 7-month pre-intervention period and the 
intervention period in the number of falls or falls injuries. Factors related to 
residents having an increased risk of falls with fractured neck of femur 
included being ambulant, having dementia, increasing age, and having a high 
falls risk assessment score.
CONCLUSION: It is difficult to change falls risk among high-risk populations, 
including people with dementia. The use of important strategies such as hip 
protectors and vitamin D and calcium supplementation increased during the study, 
probably with contamination of control facilities. Longer follow-up may be 
required to measure the impact on falls outcomes of the strategy of using a 
facilitating nurse.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry 
ACTRN12605000540617.