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Inpatient guide aims to reduce injury levels from trips and falls

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A guide for patients has been published to help prevent serious injury and unnecessary cost to the NHS caused by older people tripping or falling while in hospital.

Aimed at older patients and their families, the guide provides “easy to follow advice” and “jargon free information” on ways to help prevent inpatient falls, said the Royal College of Physicians.

“Patients and their families need to be ‘falls aware’”

Shelagh O’Riordan

The college said the guide – Falls Prevention in Hospital: a Guide for Patients, their Families and Carers – sets out a “check list of simple measures” that could minimise the risk of falling or tripping.

Advice in the 12-point checklist (see below) includes tips on exercises to improve circulation when getting out of bed or before standing, how to use walking aids in hospital safely and ensuring the bedside environment is uncluttered.

It also highlights when to ask for help with standing or walking and the importance of patients informing ward staff if they have fallen in the last year, are worried about falling, have a history of falls or feel dizzy.

Although primarily aimed at patients, the guide also highlighted clinically led interventions that should be adopted to minimise risks, including the importance of fall prevention risk assessments and medication reviews.

“We hope the guide will give patients the confidence to speak to doctors and nurses”

Shelagh O’Riordan

For example, tests should be done on vision levels, blood pressure and for the presence of delirium. Call bells should “always be within reach” of a patient, it noted, as should walking aids for those that need them.

The RCP said its falls prevention guide incorporated findings and key recommendations from its recent National Audit of Inpatient Falls. The audit revealed that simple measures, such as ensuring a bedside call bell is in sight and within reach, could greatly reduce the risk of older patients falling.

Inpatient falls are the most commonly reported hospital safety incidents, noted the college. 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.

In addition, it highlighted that around seven falls a day occur across England, Wales and Northern Ireland result in serious injuries, such as hip fracture or head injury.

Dr Shelagh O’Riordan, clinical lead for the National Audit of Inpatient Falls, said the guide was intended to encourage patients 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,” said Dr O’Riordan, who is a consultant geriatrician at East Kent Hospitals NHS Trust.

She added: “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.”

RCP 12-point checklist for patients and their carers and families:

  • Tell the nurse or doctor looking after you if you have fallen in the last year, are worried about falling, or have a history of falls
  • Use your call bell if you need help to move, in particular, if you need help going to the toilet
  • Make sure glasses are clean and used as prescribed
  • Ask for help if you are having trouble seeing
  • Use your usual walking aid, keep it close by and check for wear and tear on the rubber feet
  • Never lean on hospital furniture as it’s often on wheels
  • When getting up: sit upright for a few moments on the edge of your bed before standing; get up slowly and making sure you feel steady before walking
  • Do some simple leg exercises before getting up from your bed or chair: point your toes and release a few times; tighten the muscles in your calves and then release them; move your legs up and down if you can, to get the circulation going
  • If you feel dizzy – stop, sit down, and let the ward staff know
  • Drink regularly and eat well
  • Be familiar with your bedside environment
  • Ask for clutter to be moved if your path isn’t clear
  • Make sure your shoes or slippers fit well, grip well and cannot fall off
  • Take care in the bathroom and toilet
  • Ask for help if you need assistance
  • It is also important to make sure that you receive a falls risk assessment
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