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Nursing Times Awards 2010

Patient Safety Improvement Award

WINNER: Implementation of a multi-factorial falls prevention programme, Bhoomeela Ramnauth, Cathy Gibson and Georgina Clark, Stockport FT. Award sponsored by Safer Care

Background

Reducing falls in hospital is one of the high impact actions for nursing and midwifery, which aim to improve care and save the NHS money. This initiative aimed to improve patient safety at Stockport Foundation Trust by:

  • Reducing the number of falls;
  • Reducing the harm rate from falls;
  • Reducing the number of patients who fall more than once;
  • Ensure that falls remains a key corporate priority for everyone (from board to all staff) across the trust.

The process

The multifactorial falls prevention programme involved a range of activities and initiatives, which included:

  • Training: a specialised falls prevention and management education training package was developed and rolled out across the trust, to all levels of nursing staff and allied health professionals;
  • Bed/chair sensor alarms: after being used successfully in high-risk wards we have now rolled these alarms out across all wards in the hospital — they are used for high-risk patients, such as those who are confused or unsteady;
  • Low-profiling beds: these are rented by wards on a patient-specific basis for those who are likely to fall in the bed area and are high risk;
  • Executive team safety walkrounds: these are undertaken on a frequent basis;
  • “Safety huddles”: these are undertaken with falls collaborative wards on a regular basis to look at tests of change to be implemented and to check on progress;
  • Board involvement: a section on falls, which contains an update on falls collaborative and current incident/harm rates is now included in the monthly quality reports reviewed at board level.

Advice to other organisations

If planning similar initiatives, it is important to engage all staff at the earliest possible stage, and identify key performance indicators. It is also important to hold regular reviews and progress meetings to keep all staff motivated and enthusiastic in order to achieve the overall objectives of the initiative.

It is vital that all staff understand their roles and responsibilities in relation to the initiative, and that achievable timescales are set for all actions to be completed.

Benefits of the initiative

The implementation of this multifactorial falls prevention programme has led to joined up working across the trust and with other organisations across the north west, and has achieved board level involvement. It has improved multidisciplinary working across the trust — from all grades of nursing staff, medical staff, pharmacist, occupational therapists, physiotherapists and risk management.

The main benefit of introducing the programme is the improvement in patient safety. It also demonstrates clearly to patients, staff and visitors that the trust is committed to ensuring that we minimise the number of patient falls, and that every patient matters.

By introducing a range of falls prevention measures, and ensuring wards and staff have ownership of the project, it allows all staff to be involved in putting their ideas forward and implementing tests of change in order to reduce the number/harm rate from falls.

Financial implications

The National Patient Safety Agency estimates that the cost to the trust of falls would be £92,000 per year; based on the costs in the NPSA report the trust has so far saved £20,000 by reducing the number of falls occurring here.

Contact

For more information on this initiative please contact Cathy Gibson: cathy.gibson@stockport.nhs.uk

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