Introduction

Each year around 282,000 patient falls in acute hospitals are reported to the National Patient Safety Agency (NPSA 2010). A significant number of these falls result in death, severe or moderate injury, including around 840 fractured hips, 550 other types of fracture and 30 intracranial injuries (Jan 2011).

Slips, trips and falls have implications for Ashford and St. Peter’s Hospital as an organisation and falls are estimated to cost the NHS more than 2.3 billion pounds per year. For the individual, falls can cause distress, pain injury, loss of confidence and mortality (NICE 2013).

Those patients who at risk of a fall are most likely to be the older patients aged 65 and over ( NICE 2013) but patients of all ages may fall, due to acute illness, recovery from anaesthetic or trip hazards and underlying conditions, such as postural hypotension, anaemia, alcohol excess, low blood glucose, infection and hypoxia (Patient Safety First 2009).

There are also many known factors including poor mobility, dementia and delirium, visual impairment and the effects of their treatment or medication that can increase a person’s risk of falling.

It is accepted that falls cannot be eliminated but the risk of falling can be minimised. It is important to recognise that falls are NOT an inevitable consequence of being an inpatient or frail and that most falls are predictable and measures can be put in place to minimise a patient’s risk of falling.

The incident reporting (DATIX) in Ashford and St Peter’s NHS Foundation Trust in 2013 showed that the majority of these preventable incidences were reported to be “fall from a chair or a commode”, “found on the floor” “fall from mobilising” “fall from the bed or trolley “and fall in the toilet/bathroom”.

In some patients, the risk of falls remains despite all reasonable measures. This highlights the difficulty in observing vulnerable patients whilst also maintaining their privacy and dignity.

In these circumstances, every effort should be made to ensure that appropriate equipment and devices are available, as well as adequate staffing level are present at all times for close observation, to help reduce harm.

There are many elements of falls prevention and they are the responsibility of everyone involved with the patient including family/carer and multidisciplinary team.

It is essential to have a multifactorial risk assessment with multiple components of intervention that aim to prevent patients from falling.

 

Policy Details

Download: PDF version
Compiled by: Cecilia Chapman, Falls Lead Nurse
Ratified by: Quality Governance Committee
Date Ratified: July 2018
Date Issued: July 2018
Review Date: November 2019
Target Audience: All clinical staff
Contact name: Cecilia Chapman, Falls Lead Nurse

 

See also:

  • Close Observation Policy
  • Dementia Policy
  • Wandering Policy
  • Incident Reporting Policy
  • Learning, Education and Development Policy