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'Step by step' tool for vision assessment 'to reduce falls in hospitals'

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A new tool for hospital nurses and other professionals to quickly assess a patient’s eyesight and help prevent them from falling is to be launched at NHS trusts and local health boards in England and Wales today.

The tool, which is described as a “step by step” guide including visual aids and a set of questions and tests, is designed to be used at the bedside.

“It is incredibly important that when people are admitted to hospital staff are able to quickly assess if they have a problem”

Shelagh O’Riordan

It was developed by a number of organisations including the Royal College of Physicians, the British and Irish Orthoptic Society, the College of Optometrists, the Royal College of Ophthalmologists, the Royal College of Nursing and regulator NHS Improvement.

Results give an indication of the extent of any visual problems – known or unknown – that the patient may have.

Called Look out! Bedside vision check for falls prevention, the guide is aimed at assessing older people, whose poor vison is often linked to increased risk of falling.

Falls in hospital are the most commonly reported patient safety incidents, with more than 600 a day happening in acute hospitals and mental health trusts in England and Wales every year.

However, a recent national audit of inpatient falls by the Royal College of Physicians found less than half of older patients had a vision assessment when they arrived at hospital.

It is thought the reason was a lack of a standardised approach to basic vision assessment in acute settings. Those behind the new tool stressed though that it was not designed to replace expert clinical assessment.

“This tool allows ward staff to take patients through simple step-by-step checks which will flag up visual problems.”

Melanie Hingorani

They said it should alert staff to potential concerns that can then be communicated to medical teams for further evaluation.

Shelagh O’Riordan, clinical lead for the national audit of inpatient falls, said: “We know that poor vision is closely linked to the risk of an older patient falling or tripping in hospital.

“It is incredibly important that when people are admitted to hospital staff are able to quickly assess if they have a problem with their eyesight that needs to be managed, and perhaps even treated, as part of their care,” she said.

Melanie Hingorani, chair of the Royal College of Ophthalmologists’ quality and safety group, said: “Ward staff who have no ophthalmic experience can struggle to understand how to check vision properly.

“This tool allows ward staff to take patients through simple step-by-step checks which will flag up visual problems,” she added.

Ruth May, executive director of nursing at NHS Improvement, said it was “crucial” that clinical staff were better supported to identify patients at risk of falls.

“This guide is a great example of how the health sector can work together to develop innovative solutions and we will continue to work alongside our partners to make sure patients’ risk of falls reduce,” she said.

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