19/06/2012 - Reducing falls

#NurChat to discuss “Reducing Falls” - 19/06/2012 at 8pm

“A patient falling is the most common patient safety incident reported to the National Reporting and Learning Service (NRLS) from inpatient services. Over 200,000 falls were reported to the Reporting and Learning System (RLS) in the 12 months from September 2005 to August 2006, with reports of falls coming from 98 per cent of organisations that provide inpatient services.” (NSPA 2007) There is no doubt that slips, trips and falls have a huge impact on patients, nurses and organisations and as nurses we are all aware of the implications of falls – patient injury, loss of patient confidence and longer hospital stays are just a few.
Being able to reduce the incidence of patients falling is a nursing skill that all nurses need – identifying those at risk and being able to plan care that ensures that the patient remains independent yet safe is a key aim for all nurses. But how can we do this ? What are the key themes that we need to look out for? What tools are out there to enable us to keep the safety of our patients at the heart of their care? And what are the practical steps that we can take to reduce the risk of patients falling ?



Click on the picture to download a printable / emailable flyer to share with other nurses



Below are some links that you may find useful:

Creating protocol for reducing in patient falls - Nursing Times

Clinical practice guideline for the assessment and prevention of falls in older people - RCN  

Slips, trips and falls - NPSA

Slips, trips and falls in hospital - NSPA

The 'How to' guide for reducing harm from falls - Patient Safety First

Summary by Teresa Chinn RN

_________________________________________________________

Post Chat Summary

This was a very fast Nurchat with lots of ideas exchanged about falls and how nurses could reduce the risk of falls, a read of the transcript is a must … even if you took part !!

This chat kicked off by Nurchatters raising the subject of bed rails in relation to falls prevention, the risk of entrapment, not using the correct type of rails or using too short bumpers were all identified as key issues.

The chat rapidly moved on to assessments and the vital part they play in falls prevention. It was raised that patients conditions change and reassessment is also vital. Assessment tools were also discussed and tools that were mentioned were the traffic light system, the Tullamore assessment and the Cannard assessment.

Medication was discussed as being a key factor in some falls and sedatives and antihypertensives were agreed to be major culprits in falls.

It was asked if zero fall was achievable ? It was generally agreed that zero falls is not achievable however it was raised that a decrease in the level of harm or injury was realistically achievable.

A common thread throughout the chat was that small things matter when reducing falls – glasses, hearing aids, mobility aids, call bells, toilets, signage and shoes we all identified as key. Age Uks sloppy slipper campaign was raised and explained – how Age UK are exchanging ill fitting slippers for well fitting ones with the aim to reduce falls. Nurchatters were encouraged to use and follow #sloppyslipper.

Intentional rounding was discussed and considered to be an important way of reducing falls. However it was raised that intentional rounding needs to be at appropriate time intervals and that there are those who require more intervention due to an increased risk.

Reporting and route cause analysis to decrease the risk of future falls was debated and was agreed that this is essential. It was raised that incident reporting may identify key themes or trends. A project at the Royal, Devon and Exeter Hospital was cited – where they used ward maps to identify the locations of each fall with a dot, they were then able to locate areas where patients were more at risk of falls and make improvements.

The environment was another key area of discussion with extra beds in bays, flooring, location of loo roll, cluttered environments and clear signposting all seen as important factors to consider when assessing risk of falls by NurChatters.

Finally it was discussed that we must also consider staff in relation to falls, a few NurChatters told stories of falls they had and it soon became very clear that we must not only consider patient falls but also staff falls... all can be life changing and all need to be reduced.  

By Teresa Chinn RN
__________________________________________________________

Chat transcript