The Royal College of Physicians (RCP) has produced Falls Prevention in Hospital: a Guide for Patients, their Families and Carers, a guide designed to help prevent serious injury and unnecessary cost to the NHS caused by older people tripping or falling when they are in hospital.
Aimed at older patients and their families and carers, the guide provides easy to follow advice on what patients and those in contact with them can do to help prevent inpatient falls. Falls Prevention in Hospital: a Guide for Patients, their Families and Carers provides jargon free information on the care patients can expect to receive in hospital, as well as advice on how to be alert to potential dangers and what to do to avoid them. It sets out a check list of simple measures that, when undertaken, can minimise the risk of falling or tripping.
Advice in the checklist includes:
- Tips on exercises to improve circulation when getting out of bed or before standing
- How to use walking aids in hospital safely
- Ensuring the bedside environment is uncluttered and prescription glasses and walking aids are to hand when standing
- When to ask for help with standing or walking
- The importance of patients informing medical staff if they have fallen in the last year, are worried about falling, have a history of falls or feel dizzy.
Inpatient falls are the most commonly reported hospital safety incidents. More than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales every year, which equates to more than 600 a day (1). Around seven falls a day occur across England, Wales and Northern Ireland result in serious injuries, such as hip fracture or head injury (2). Falls in hospitals are costly to the NHS, as they increase the length of patient stay and may require increased care costs upon discharge.
More than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales every year, which equates to more than 600 a day.
Research has shown that interventions from multidisciplinary teams, tailored to patient needs, can reduce the incidence of falls by 20-30% (3). The RCP’s recent National Audit of Inpatient Falls revealed that simple measures, such as ensuring a bedside call bell is in sight and within reach, can greatly reduce the risk of older patients falling (4).
The RCP falls prevention guide incorporates the audit’s findings and key recommendations. It also advises on clinically led interventions that should be adopted to minimise risks, including the importance of fall prevention risk assessments and medication reviews.
Dr Shelagh O’Riordan, Clinical lead for the National Audit of Inpatient Falls said:
When a patient falls in hospital, particularly an older patient, it can cause anxiety and distress for them and their families, even if the fall does not result in serious injury. The RCP falls prevention guide informs patients and their families about the need to be ‘falls aware’. It encourages them to be alert to risks and how these risks can be minimised. It also covers measures that hospital staff should take to reduce the risk of patient falls.
We hope the guide will give patients and their families the confidence to speak to doctors and nurses about any concerns they might have and encourage them to be pro-active in helping prevent people falling and hurting themselves while they are being treated in hospital.
Falls Prevention in Hospital: a Guide for Patients, their Families and Carers, is available to download free from the RCP website. Hard copies are also available. Go to the Falls and Fragility Fracture Audit Programme (FFFAP) or contact falls@rcplondon.ac.uk for more information.
- National Patient Safety Agency. Slips trips and falls data update. London: NPSA, 2010.
- Royal College of Physicians. National Hip Fracture Database annual report 2015. London: RCP, 2015.
- National Patient Safety Agency. Slips trips and falls in hospital. London: NPSA, 2007
- Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. The Cochrane database of systematic reviews 2012(9):CD007146. doi: 10.1002/14651858.CD007146.pub3
- Royal College of Physicians. National Audit of Inpatient falls: audit report 2015. London: RCP, 2015
To receive a copy of the guide, please contact RCP communications manager Jane McCormick on 020 3075 1354, or email: jane.mccormick@rcplondon.ac.uk.
About the RCP’s National Audit of Inpatient Falls
The RCP’s 2015 National Audit for Inpatient Falls revealed that some hospital trusts are achieving good results through carrying out falls risk assessments on inpatients over 65 years old. However it also noted that there was room for ‘substantial improvement’ in most key areas of falls prevention, such as ensuring walking aids are within easy reach.
The National Audit of Inpatient Falls is part of the Falls and Fragility Fracture Audit Programme (FFFAP). Commissioned by the Healthcare Quality Improvement Partnership (HQIP)*as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), this audit builds upon previous pilot and feasibility audits (RCP, 2011, 2014).
*About HQIP, the National Clinical Audit Programme and how it is funded
HQIP is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP holds the contract to manage and develop the National Clinical Audit Programme (NCA), comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands.