Falls

In order to achieve the overarching goal, the falls prevention programme aims to reduce harm from falls by:

• raising awareness of the 'How to' guide and all relevant partner resources
• supporting local leaders and frontline staff to reliably implement best practice
• creating a ‘virtuous circle’ of local and national learning from falls
• exploring ways of improving care after an inpatient fall (prompt detection and treatment of injury)
• eveloping materials for local trusts to use for staff education.

Recognising the impact of falls on patients and staff, Brighton and Sussex University Hospital (BSUH) launched an initiative in 2009 which aimed to reduce the number of inpatient falls across the Trust. The initial positive results waned and fluctuations between months and departments led to an overall failure to meet the initial target. In the spring of this year a senior nurse was seconded into a dedicated safety post. Phase II centered on a reduction in Falls in the Barry Wing where there is a concentration of elderly care and medical wards with some of the highest falls rates. This case study discusses this project and the results to date. 

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‘Delirium is a state of mental confusion often known as ‘acute confusional state’ that is common, often missed by healthcare professionals, preventable in up to a third of all cases and largely treatable. It can be a particular problem in the management of older people and can contribute to a higher incident of patient falls.

The Department of Medicine for Older People Rehabilitation and Stroke at Portsmouth Hospitals NHS Trust have developed a comprehensive guideline for the diagnosis and management of older people with delirium. Under the headings ‘Spot it, Treat it, Stop it’ the guide helps the reader recognize delirium, diagnose underlying causes and manage the patient and their family or carer(s)’. Click on the following links to download copies of the resources.

• Guidelines for the diagnosis and Management of Older People with Delirium
• Root Cause Analysis - Guidance for Falls Link Champions.

Neurological observations are critical not only after an inpatient fall with head injury, but for patients with a range of other conditions. But taking and recording neurological observations correctly and recording them clearly and consistently is a challenge, with some trusts still using outdated formats of the Glasgow Coma Scale or locally photocopying charts until over time they become blurred and unclear.

At University Hospitals Leicester, Martin Wiese, consultant in emergency medicine, has developed clearly laid out charts where the reverse gives detailed instructions, complete with photographs, on exactly how to collect and interpret ‘best motor response’. Click on the following links for examples of these charts:

• UHL neurological observation chart - adults and children over 5
• UHL neurological observation chart - children under 5.

For free access to an article that works through applying the 'How to' guide for reducing harm from falls in settings specialising in older people’s care, click on the image below.

During Patient Safety First week 2010, the James Paget University Hospital NHS Trust falls prevention team coordinated a trust-wide roll out of their ’10 Key Responsibilities for Preventing Falls’.

• Observation rounds
• Equipment
• Footwear
• Bed/bed rails
• Assessment
• Visible
• Medication
• Call bell
• Environment
• Documentation.

This forms the start of a series of ‘10 Key Responsibilities’ that will be developed by the Patient Safety Project team. Click here to download a poster of the 10 key responsibilities.

The ProFaNE Online Community is an active working group of Health Care Practitioners, Researchers and Public Health Specialists dedicated to the prevention of falls in Europe and beyond.

Click here to visit the ProFaNE website.

Throught 2011 AQuA are holding free onlne webinar sessions covering topics related to falls prevention. Click here to download the programme and registration details.