Prevention and Management of Adult Inpatient Falls

Introduction

Falls and fractures are often preventable; falls in hospitals are the most commonly reported patient safety incident with more than 240,000 reported in acute hospitals and mental health trusts in England and Wales.

Over half a million over-65s end up in UK Emergency Departments every year following a fall with nearly 40% suffering some fracture due to osteoporosis. These injuries result in over four million bed-days in England alone, costing around of £2 billion and often leading to disability and loss of independence. They are the primary cause of accidental death in this age group. The busy, fast-paced environment of the Emergency Department (ED) creates an especially high risk area for falls (Bell et al. 2000; Lightbody et al. 2002, Rosenthal 2011).

The ability to accurately identify patients at risk from falling at the point of entry is the first step towards preventing patient harm. It is valuable to have interdisciplinary collaboration on falls prevention at the time of presenting to ED between admitting doctors, nurses, occupational therapist, physiotherapist, and pharmacists (Lancaster et al. 2007, Rosenthal 2011, Alexander, Kinsey and Waszinski 2013).

The human cost of falling includes distress, pain, injury, and loss of confidence, loss of independence and increased morbidity and mortality. Falling also affects the family members and carers of people who fall, and has an impact on quality of life, health and social care costs.

The causes of falls can be multifactorial, with many risk factors having a contributory effect. These include: environmental hazards, muscle weakness, poor balance, visual and sensory impairment, medical conditions such as dementia or delirium, polypharmacy – and the use of certain medicines.

All Staff have a responsibility to ensure risks associated with falls are considered to ensure patient safety is maintained. Patients have the right to make their own decisions; there may be times when a patient with full capacity chooses to refuse the care and recommendations set out by staff; this must be clearly documented.

Ashford & St Peter’s Hospitals NHS Foundation Trust are committed to providing consistent, evidence based quality care in the prevention, management and treatment of falls for all inpatients. This will incorporate a holistic assessment and demonstrate patient/carer involvement in the care provided.

Policy Details

See also:

• Trust Strategy
• Trust Harms Free Care Strategy
• Dementia Care Policy
• Incident Reporting Policy
• Education, Learning, and Development Policy
• Enhanced Care Supportive Observation and Therapeutic Engagement Policy
• Bedrails Policy
• Moving and Handling Policy
• Slips, Trips, and Falls Policy (Non-Patient Policy)