Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project

Abstract

: introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates.

The Royal College of Physicians’ Fallsafe care bundles applied trustwide: the Northumbria experience 2013

“…Although the trust has had a robust nurse-led patient incident reporting culture (reinforced during mandatory training and post-fall follow up) for many years, and we were confident all falls were reported, because we did not use the FallSafe under-reporting measure 5 we cannot confirm whether this was actually the case. Therefore changes in reported falls may reflect more complete reporting.…”

“…Falls/1,000 bed day rates are similar to that reported in wards equivalent to the FallSafe wards at the end of the intervention. 5 The number of inpatient falls can be affected by many factors including environmental, staff and patient factors. A dedicated falls team is essential to provide the necessary training and support to implement the FallSafe care bundles.…”

“…3 The Royal College of Physicians' (RCP's) FallSafe quality improvement project took the successful components and formed them into care bundles to prevent and manage falls in clinical hospital wards in Southern England SHA. 4,5 The FallSafe care bundles therefore represent measures of good practice, some of which are recommended for all patients, some are additional measures for older and more vulnerable patients admitted to hospital, and there is another bundle for after an inpatient fall, to reduce the number of inpatient falls (Box 1).…”

A Compendium of Safety Strategies and Interventions

“…The standard intervention has been shown in large randomized controlled trials to have little effect; the more personalized approach, which stresses an adaptive response to risk, is proving very much more effective. Healey comments that this 'makes complete sense in the context of falls risk being a complex combination of intrinsic and extrinsic factors and personal attitudes to risk, in an acute environment where physical condition and therefore falls risk factors are rapidly changing' (Healey et al 2014 andpersonal communication 2015).…”

Older, in hospital and confused – The value of nursing care in preventing falls in older people with cognitive impairment

“…They are designed to improve processes of care and encourage clinical practice guideline compliance. Various care bundles have been developed for a variety of clinical populations and recently have been developed for patients at risk of falls (Healey et al, 2014;Neyens et al, 2011;Teresi et al, 2013;Milisen et al, 2013), showing some promising results.…”