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Resource update: Preventing falls in hospital

Read our guidance to a resource from the Royal College of Physicians on preventing falls in hospital.
Call_Bell-JH_1057.jpg

Read our guidance to a resource from the Royal College of Physicians on preventing falls in hospital

Preventing falls in hospital

Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 per day, according to the Royal College of Physicians (RCP).

But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%. In October, the RCP published a new resource, aimed at patients, their carers and families, to help prevent falls in hospital. It features a 12-point checklist and recommendations for staff, which follow those

Read our guidance to a resource from the Royal College of Physicians on preventing falls in hospital


The RCP published a new resource, aimed at patients, their carers and families, to help
prevent falls in hospital. Picture: John Houlihan

Preventing falls in hospital

Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 per day, according to the Royal College of Physicians (RCP). 

But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%. In October, the RCP published a new resource, aimed at patients, their carers and families, to help prevent falls in hospital. It features a 12-point checklist and recommendations for staff, which follow those arising from the RCP’s national audit of inpatient falls, carried out in May 2015.  

Key recommendations include: making sure call bells are within a patient’s reach; assessing a patient’s vision when they are in hospital; reviewing medications and changing them if needed; making sure walking aids can be reached easily; measuring lying and standing blood pressure; testing for dementia or delirium; checking footwear is safe; developing a continence care plan for those who need it; and removing clutter and obstacles from bedsides. Staff should also check whether bedrails are being used properly and appropriately. 

The booklet highlights those areas where hospitals can improve care, based on current audit findings. For example, just 16% of patients had their lying and standing blood pressure measured, while only 37% were assessed for delirium. In contrast, more than 80% of patients could see and reach their call bell.

‘We felt that while many hospitals have good falls policies, many had difficulty putting this into practice,’ says the RCP guidance. 

Implications for nurses

‘Preventing falls in hospital is a job for all staff in all hospitals,’ says the RCP. It recommends that everyone aged 65 or over, plus those aged above 55 who are deemed at risk, should have a multifactorial falls risk assessment, which may be carried out by a nurse or doctor. This process should include all the elements recommended by the National Institute for Health and Care Excellence (NICE), in their guidance. All hospitals should also have a special staff falls group that includes nursing representatives. Once patients have been assessed, staff should alter care accordingly to reduce risks. 

Expert comment

Dawne Garrett, RCN professional lead for older people and dementia care:

‘I like the patient focus of this guidance and that’s something that we need to do more. It’s simple, clear things that people can do to help themselves in a useful and attractive format. It will help nurses a lot, especially by putting the onus on people to explain their needs. It’s empowering for patients to be told that they don’t have to struggle to the bathroom alone, and they should ask for someone to accompany them. The more patients feel a sense of autonomy and ability to influence their care, the better. We need more patient-prompted and involved care.’  


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