Aim: Reduce the number of falls resulting in harm by 20% by March 2017
from our 2015 baseline
Patient falls are one of the most common patient safety incidents reported. The majority of slips, trips and falls result in low or no harm to patients physically. However, any slip, trip or fall can result in the patient losing their confidence. There have been significant improvements within all areas of the Trust in reducing the numbers of falls over the last few years and a number of initiatives introduced during 2013/14 to promote the reduction in falls resulting in harm. In line with the continuing improvement drive and to support the delivery of the Trust Strategic Framework, one of the Trust Quality Goals has been identified as reducing patient harms as a result of a fall. This driver diagram sets out how we aim to achieve this.
There have been a number of initiatives introduced throughout the Trust to promote the reduction in falls resulting in harm.
- There has been targeted support and training given to wards within both the Scheduled and Unscheduled Divisions to improve the staffs understanding in relation to bone health and falls risks this included education around the falls risk assessment and the formulation of a care plan for patients at risk of falling.
- Introduction of movement sensors in all the clinical divisions, both on the acute wards and in the community hospitals, for patients who are identified to be at high risk of falling. The sensors are discreet and can be placed either under the mattress of the bed, or on the chair if the patient is sitting out of their bed. The sensors alert the ward nurses via a pager system if a patient attempts to get out of bed or move from the chair unaided. The sensors have already helped prevent potential injury to patients as the nursing staff have been alerted swiftly and assistance given.
- Low beds have been trialled and the Trust has introduced these to prevent falls for those patients at higher risk.
- A footwear trial has been completed and we have changed the products used across the Trust
- We have developed a slipper exchange scheme in the care of the older adult wards
- Greater cross boundary working with colleagues working in the community.
- Intentional rounding, in the form of a safety bundle has been introduced into all clinical areas.
Intentional rounding is a checklist approach to check on all patients hourly to ensure they are receiving safe, harm free care. The intentional rounding tool covers all aspects of nursing care and enhances the care given, contributing to the reduction of harm. In particular serious falls have significantly reduced.
Robust risk assessments are key to identify the patients who are at high risk of falling. The Trust has made major improvements in the care planning process, following initial assessment undertaken by the Nursing staff. Care plans reflect the needs of the patients following assessment, and this ensures that the patients receive the most appropriate support to reduce their risk of falling.
The Trust has also introduced hourly rounds / visits to patients that are identified as being at high risk of falling. This has proved to be very successful and has shown a 60% reduction in the number of falls within the Cardiac Centre and significant improvements have been seen in other specialities.
Intensive support has been introduced to the areas where it has been highlighted that there have been a number of falls in the previous month. Regular feed back to staff is provided regarding the number of falls within their areas. Additionally, there are visual aids such as the safety crosses that display at a glance the numbers of falls patients have experienced within the ward area. This data is displayed within the quality boards on the wards so that this information is shared with the patients, staff and the public.