Hospitals need to do more to prevent falls, audit finds

Simple safety measures to prevent frail and older patients from falling are receiving scant attention in some hospitals, and there is considerable room for improvement, the National Audit of Inpatient Falls has found

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Simple safety measures to prevent frail and older patients from falling are receiving scant attention in some hospitals, an audit has found.

The National Audit of Inpatient Falls said hospitals have considerable room for improvement in preventing falls.

There were about a quarter of a million falls in NHS hospitals in England in 2015-16, data published in July by NHS Improvement showed.

Slower recovery

These resulted in more than 2,500 hip fractures, distress for patients and their families, and for some a slower recovery from the illness that saw them admitted to hospital in the first place.

The latest audit, by the Royal College of Physicians, says some hospitals are not undertaking basic steps regarding patients’ risk of falls, the majority of which occur to people over the age of 65.

For example, 28% of patients who needed access to a walking aid could not reach it, and almost one in five patients or 19% could not reach their call bell, the audit found.

Access to call bell

'The highly variable rates for patients having easy access to the call bell suggests that this simple safety measure is receiving scant attention in some hospitals,' the authors wrote.

'We recommend a hospital-wide approach to address this.’

Meanwhile, all patients who need walking aids should have access to them from the time of admission, they said.

While falls cannot be entirely prevented there are some steps that hospitals can take to reduce a patient's risk, the report said.

Best practice

If hospitals adhere to best practice guidance, around 20% to 30% of falls could be prevented, it said.

Researchers gathered data from 97% of the hospital trusts and health boards in England and Wales.

They found that the rate of some methods for preventing falls showed improvements between the 2015 audit and the 2017 audit such as blood pressure measurements, delirium assessments and mobility aids being in reach, which rose from 68% in 2015 to 72% in 2017.

'However, these rates leave considerable room for improvement in most trusts,' they said.

Key measures

They found no significant improvements in other key measures including:

  • Having a continence care plan in place.
  • Patients undergoing a vision assessment.
  • Patients having a call bell within reach.
  • Whether or not they had been assessed for medications that increase falls risk.

The authors said: 'There was substantial variation in levels of assessments and interventions between hospitals, more than can be explained reasonably by variations in case mix or the range of good clinical practice.'

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