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FALLS PREVENTION

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					FALLS PREVENTION


• Greater Glasgow and Clyde falls
  prevention service
OBJECTIVES


• Education/Training to all GGC staff in falls
    prevention.
•   Awareness of HFP service referral criteria.
•   Implementation of the research based
    inpatient falls prevention multidisciplinary/
    multifaceted approach
•   Audit activity to monitor standards of care
Glasgow Hospital Falls Facts
• 8500 falls in 2006 prior to hosp falls
  service.

• 7991 falls and 82 fractures 2007-2008
• 5445 falls and 51 fractures 2008-2009
WHY FALLS OCCUR

•   Medical condition
•   Medication – polypharmacy/culprit meds
•   Previous fall – loss of confidence
•   Muscle weakness
•   Gait and balance disturbances
•   Confusion / Poor safety awareness
•   Incontinence
•   Visual/hearing impairment
•   Footwear
•   Environmental hazards
COMMON TRENDS IN FALLS

   • Not witnessed
   • Between bed/chair and toilet
   • Usually associated with a
     basic need i.e. getting a
     drink, going to the toilet
IMPLICATIONS OF A FALL


  • Personal impact to patient
  • Prolonged hospitalisation
  • Mortality and morbidity
  • Potential litigation
FALLS RISK ASSESSMENT
DOCUMENTATION
Multidisciplinary/Multifaceted
Interventions

    • Medical assessment
    • Pharmacy review
    • Nursing assessment
    • Physiotherapy assessment
    • Occupational Therapy assessment
    • Safe patient environment.
Referral Criteria for Hospital Falls
Prevention Service

• Cannard Score 18+

• 2 or more falls

• Fall with significant injury

(N.B. any of the above)
EQUIPMENT AVAILABLE

  •   Hi-low beds
  •   Enterprise 5000 beds
  •   Bed monitors
  •   Chair monitors
  •   Adjustable height seating
  •   Specialist seating
  •   Non slip mats / one way glides
SPIRIT ULTRA LOW BED
BED RAILS
• Rationale for use/bed rail risk assessment.

• Regular review of decision making.

• Are bedrails fit for purpose?

(N.B.- NPSA recommend all health boards
  should have a bed rail policy)
AUDIT


 Ongoing audit by HFPC in compliance
 with falls documentation and
 maintaining a safe ward environment.
                                                            Patient   1     2      3      4      5      6      7         8         9      10
1.Is the patient’s chair at appropriate height                        Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
( i.e. patients can sit on chair with feet resting on the floor)       No    No     No     No     No    No      No        No        No    No
(patients in wheelchairs are footplates in use)                       N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
2. Is the patients bed in the low position                            Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
(even if patient is not presently in bed)                              No    No     No     No     No    No      No        No        No    No
                                                                      N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
3. Is the patient buzzer within arms reach                            Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
                                                                       No    No     No     No     No    No      No        No        No    No
                                                                      N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
4.Can the patient access personal belongings at arms reach            Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
(If patient able ask patient to reach for an item of personal          No   No      No    No      No    No     No        No         No     No
belongings)                                                           N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
5..Have all non- essential items which would impact on the            Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
patients safety been removed from patients bedspace                    No    No    No      No     No     No    No        No        No     No
(inspect bed space for i.e. dynamaps / cables / clutter)              N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
6.If the patient uses a walking aid independently – is walking aid    Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
within reach                                                           No    No     No    No     No      No     No        No        No     No
(ask patient to reach for walking aid , if able)                      N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
7.Are bedrails used when this patient is in bed                       Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
                                                                       No    No     No    No     No      No     No        No        No     No
8.Is reason for bedrail use recorded in patients notes i.e. bedrail   Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
risk assessment                                                        No    No     No    No     No      No     No        No        No     No
(Check with staff) note if used as restraint or moving & handling     N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
aid
9.Detail the reason for using the bedrails : i.e. sided weakness/
patient requested
10. Cannard score for this patient =
11.Has a Cannard risk assessment been initiated within 24 hours       Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
of the patients admission to this ward (check nursing notes)          No     No     No    No      No    No     No         No        No    No
                                                                      N/A    N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
12.Has the risk assessment been up dated in line with the policy      Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes    No Yes    Yes
(check nursing notes)                                                 No     No    No      No    No      No    No        N/A       No     No
                                                                      N/A   N/A    N/A    N/A    N/A    N/A    N/A                 N/A    N/A
13.Has a care plan been initiated                                     Yes   Yes    Yes    Yes    Yes    Yes    Yes       Yes       Yes    Yes
(check nursing notes)                                                 No    No     No     No      No     No     No        No        No    No
                                                                      N/A   N/A    N/A    N/A    N/A    N/A    N/A       N/A       N/A    N/A
14.Has the care plan been up dated in line with the policy            Yes   Yes    Yes    Yes    Yes    Yes    Yes    No Yes       Yes    Yes
(check nursing notes)                                                 No    No     No      No    No     No     N/A        No       No      No
                                                                      N/A   N/A    N/A    N/A    N/A    N/A              N/A       N/A    N/A
15.How many has the patient experienced since their admission to
this ward
(check Medical notes)
Can Interventions Make a Difference?
2008-2009 – 32% reduction in falls and
            38% reduction in fractures
            throughout all Glasgow
            Hospitals.

				
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