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Falls Prevention & Promotion

Falls Prevention & Promotion. Deborah Birch Consultant Nurse for Frailty. Impact of falls. A fall in hospital can result in an average increase in stay 1-2 days. Research has shown that multiple interventions performed by MDT & tailored to individual can reduce falls by 20-30%.

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Falls Prevention & Promotion

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  1. Falls Prevention & Promotion Deborah Birch Consultant Nurse for Frailty

  2. Impact of falls • A fall in hospital can result in an average increase in stay 1-2 days. • Research has shown that multiple interventions performed by MDT & tailored to individual can reduce falls by 20-30%. • Falls are estimated to cost the NHS more than £2.3 billion per year (NICE, 2013) and rising

  3. Falls related Anxiety cycle

  4. Lincolnshire

  5. Lincolnshire Demographics Interesting facts 1st policewoman - Edith Smith 1915 (Grantham) • Population of 743,400 • Large proportion of Rural, Retirement • Proportion of people over 75yrs projected to increase by 95% bet 2014-2039. • 4 x CCGs Home to one of only four surviving copies of the Magna Carta Invented the tank

  6. Lincolnshire……

  7. Aims: • Journey so far within ULHT • NHS Improvement collaborative • Ongoing initiatives

  8. Reported falls per 1,000 OBD’s The NPSA calculated the mean rate of falls per 1,000 OBD’s as 5.6 for acute hospitals

  9. The Journey…… • Deputy Chief Nurse with falls remit as part of safety remit - Reinvigorated Trust Falls Group - Monthly Falls Scrutiny Panels • 1st Falls Summit to increase staff awareness • Developed Falls Workbook

  10. Trust Wide Falls Group • Lead • Jenny Hinchliffe (Interim Lead Nurse /Patient safety manager) • Representation from across all sites • Medics, OT, Physio, Nurses, Risk Management • Monthly • Forms part of Ward Accreditation

  11. Falls Scrutiny Panels • The ULHT Falls Scrutiny Panel is a sub-committee of the ULHT Falls Group. • The panel forms part of the Trust’s overall assurance process relating to protecting patient’s safety. • All patients who have sustained severe harm following a fall while in ULHT. • Ward Sister presents timeline to panel • Identifies areas of good practice and gaps in care. • Helps to identify trends • Action Plan

  12. Falls Summit

  13. Falls Workbook

  14. NHS Improvement Falls Collaborative Programme • 90 day improvement cycle aimed at improving the management of falls in the inpatient setting in 19 Trusts • Re-energise the falls prevention improvement movement and ensure that providers have the information, skills and tools to reduce injurious inpatient falls and improve reporting and care • Aimed to achieve a 5% reduction in falls rate • PDSA cycles used to share improvements

  15. Wards involved Ward 3B Trauma Orthopaedic Ward Ward 6B Complex Care of Older Males Ward

  16. First Step:Falls Workbook role out

  17. PDSAa way of testing change

  18. PDSA: Cycle One • Medications • Plan: To Improve the knowledge and awareness of the ‘Red Flag’ medications on each ward. • Do: To place medication prompts of the top 10 risk medications in relation to falls on medication trolleys/ clinical rooms • Study: Pre audit number of recognizable drugs know to staff. Then re-audit monthly • Act: Role out

  19. PDSA: Cycle Two • Lying and Standing Blood Pressure Recording • Plan: To improve the compliance of L&S BP by 75% • Do: To apply stickers into patients notes as a prompt to undertaking the L&S BP • Study: Monitor SQD results • Act: Role out

  20. PDSA: Cycle Three • Fall Hot Spots • Plan: To identify main areas where falls take place • Do: Populate scatter graph onto a ward layout map • Study: Monitor for ‘hot spot’ • Act: ongoing

  21. Falls incidents Wards 3B & 6B

  22. Falls per 1000 bed days Ward 3B

  23. Falls per 1000 bed days Ward 6B

  24. What has the journey taught us so far…. • The need for a whole system approach to change. • The need to change the attitude and culture of falls • That reducing falls needs to be multi faceted • That education and knowledge is power • Small changes lead to a big change

  25. Next steps • Need to consider ‘Multiple Falls’ and the role of safety huddles • Development of e-learning training package to support workbook • Role of L&S stickers across all sites • Role out Medications prompts across all sites • Develop falls ambassadors • Falls as part of the metric for ward accreditation

  26. Ultimately …We need to change the Culture to how we view a fall..

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