More needs to be done to prevent falls in hospital

Although the prevention of inpatient falls across hospitals in England and Wales has slightly improved, many patients are not receiving the required assessments which can help prevent falls in hospitals, a new report shows.

The report by the Royal College of Physicians (RCP), National Audit for Inpatient Falls (NAIF) report 2017, reveals that since 2015 many trusts and Local Health Boards (LHBs) have stopped using ‘falls risk screening or prediction tools’ - a drop from 74 per cent to 34 per cent.

These tools do not sufficiently predict who will fall in hospital and means patients may not be assessed correctly and therefore at more risk of falling.

Everyone over the age of 65 should be regarded as being at risk of falling in hospital and considered for a multi-factorial falls risk assessment (MFRA), as recommended by NICE.

The MFRA aims to uncover anything that might make a person more likely to fall and see whether there are specific things that can be done to prevent this. This may include checking their eyesight and their balance and mobility.

The report also reveals that while 72 per cent of patients had their level of mobility recorded, only 40 per cent were assessed for the presence of delirium, which is strongly associated with falls in hospital.

Falls in hospitals result in longer hospital stays for patients and falls risk assessments can help in saving trusts resources at a time when they are overstretched.

The report highlights that some trusts and health boards are doing all they an to prevent falls in hospitals and they did improve in some or most of the key indicators, showing that good practice is possible and should be prioritised in all trusts.

The report’s key recommendations include: not using a fall risk prediction tool, utilising walking aids, checking for visual impairment, checking lying and standing blood pressure, and reporting all falls in hospital with the correct level of harm.

This report is the second audit report and shows data on over 5,000 patients aged 65 years or older across 198 hospitals and 146 trusts in England and Wales.

NAIF is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and managed by the RCP, as part of the Falls and Fragility Fracture Audit Programme (FFFAP).

Shelagh O’Riordan, NAIF clinical lead, said: “This is the second time there has been a national audit of falls prevention in hospitals across England and Wales. Our results show that although there are areas of really good care, and significant improvements have been made by some hospitals, many hospitals are still not doing everything they can to prevent falls.

“I hope this audit can help clinical teams work towards reducing the number of falls currently happening in hospitals in England and Wales.”