FallSafe Collaborative in Community Hospitals

Objectives and concerns

Concerns

Falls and fall-related injuries are a common and serious problem for older people. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. (NICE Guideline CG161: Falls in older people: assessing risk & prevention).

The project is based upon the ‘FallSafe’ bundle and aims to identify current compliance to multifactorial falls assessment and therefore the areas where improvements can be made. The aim is to ensure that patients across all Community Hospital wards have a thorough, high quality assessment on admission in relation to their falls risk. This in turn, should ensure appropriate interventions are in place to prevent falls where possible, and to reduce harm caused by falls.

Objectives

  • To reduce the number of falls in community hospitals
  • To reduce harm from falls in community hospitals
  • To ensure accurate and high quality falls risk assessment, management and planning

Aim

By May 2020 all participating community hospital wards will have improved their falls risk assessments, by achieving and sustaining 85% completion of each element of the FallSafe bundle.

Sustaining is defined as 85% completion of each element for at least 5 consecutive measurements.

About this project

7 community Hospital wards across Oxford Health Trust joined the project to understand why people fall in their wards and to implement the Fall Safe bundle. Work includes looking at the environment, special focusses on identifying postural drops and correct and accurate communication of bed rail use.

Outcomes

The run chart below shows an improvement towards the aim of the project of the combined wards data.

The table below shows results for wall wards combined broken down into each individual item.

 FallSafe Elements Baseline March/April 2019 July 2019 Sept 2019 Nov 2019 Jan 2020
Observe: call bell in sight and reach? 84% 91% 92% 90% 93%
Observe: safe footwear on feet? 99% 96% 99% 99% 100%
Notes: falls risk assessment completed? 90% 100% 100% 99% 98%
Notes: falls risk assessment completed within 6 hours of admission? 46% 71% 66% 70% 61%
Notes: asked about history of falls? 73% 72% 79% 80% 77%
Notes: asked about fear of falling? 77% 90% 85% 78% 84%
Notes: urinalysis performed / consideration given to clinical symptoms of UTI? 49% 79% 71% 47% 56%
Mobility assessment within 24 hours? 93% 95% 94% 91% 96%
Drug card: avoided night sedation last night? 89% 90% 89% 91% 92%
Notes: cognitive screen? 72% 92% 77% 78% 71%
Charts: lying and standing BP taken manually? 24% 62% 63% 67% 59%
Notes: bedrail assessment and/or consideration of ultra-low bed? 84% 79% 73% 87% 90%

This project was stopped during the pandemic but individual wards continue to maintain the changes put in place and work towards reducing falls.

Non-urgent advice: Further information

Local project leads

  • Bicester – Steph Dau, Advanced Nurse Practitioner
  • Wallingford – Siobhan Bennett, Clinical Development Nurse
  • Didcot – Virgilyn Guillermo, Clinical Development Nurse
  • Witney – Karen Dawson, Clinical Development Nurse & Helen Moir, Ward Manager
  • Abingdon – Katrina King, Ward Manager & Julia Marren, Clinical Development Nurse

QI project support

  • Ann De Vita, Clinical Lead Physiotherapist
  • Helen Hunt, Senior Improvement Lead
  • Hayley Trueman, Improvement Lead

Page last reviewed: 23 July, 2021