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Give a ‘cwtch’ after a fall – a checklist to help older patients

Nursing homes staff in Wales are trialling a new catchphrase checklist to help reduce hospital admissions after older patients have taken a fall

Nursing homes staff in Wales are trialling a new catchphrase checklist to help reduce hospital admissions after older patients have taken a fall

Nurses in Wales are trialling a new ‘catchy’ checklist to help reduce hospital admissions after older patients have a fall.

‘Cwtch’, which means hug in Welsh, is being used as a mnemonic to help staff make the right decisions after an older patient has taken a tumble.

Leaving a patient on the floor can cause serious physical problems

Traditional best practice states that when older people have fallen,

Nursing homes staff in Wales are trialling a new catchphrase checklist to help reduce hospital admissions after older patients have taken a fall

‘Cwtch’ (which means hug in Welsh) is used as a mnemonic to help nursing staff to make the right decisions after an older patient has taken a tumble.
‘Cwtch’ (which means hug in Welsh) is used as a mnemonic to help nursing staff to make the right decisions after an older patient has taken a tumble. Picture: iStock

Nurses in Wales are trialling a new ‘catchy’ checklist to help reduce hospital admissions after older patients have a fall.

‘Cwtch’, which means hug in Welsh, is being used as a mnemonic to help staff make the right decisions after an older patient has taken a tumble.

Leaving a patient on the floor can cause serious physical problems

Traditional best practice states that when older people have fallen, they should not be moved and they should not be given any food or drink until an ambulance arrives.

But this approach is being turned on its head by nurses at the Swansea Health Board, who say leaving a patient on the floor can cause serious physical problems, such as pneumonia or dehydration, exacerbated by longer ambulance waiting times.

‘We are trying to change the narrative out there and say that if they can be moved then we need to move them,’ said Swansea Bay University Health Board emergency nurse practitioner Debra Clee said.

‘We are finding that they are being admitted, not because of the fall but because of the long lie, as we call it.’

Cwtch’s five-point plan for dealing with a fall

C- Can you move them?

W- Will it harm them – for example by causing any new neck or back pain?

T- Treat – dress wounds or offer pain relief

C- Cup of tea – offer a drink or food after a fall

H- Help – know when to call an ambulance or a doctor

‘Cwtch’ system will be rolled out to the wider region

The system developed by Ms Clee has been introduced in nursing homes in Swansea and will be rolled out to the wider region.

She added: ‘When you hear stories about someone never recovering from a fall, often it’s not the injury itself but being left on a hard surface for a very long time.

‘This can cause acute kidney problems, it can give them pneumonia, it can cause muscle tissue to break down.

‘If they are not being given anything to eat or drink they can become dehydrated. By the time they come to us they are not fit for surgery – if it’s needed – and are quite unwell.’

Ms Clee said there were circumstances where a patient should not be moved, but even on those occasions the patient can usually be offered painkillers and something to eat or drink.

But noted that someone left on the floor for hours will almost certainly need an ambulance and usually admission to hospital.


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