Ward sister, Gemma Lilley, shares with us the strategies that have led to the number of falls on her ward being halved
All falls lead to some amount of harm, whether that’s physical, emotional or psychological.
I have been a ward sister on a busy surgical ward for three years now and as a team we have worked hard to reduce falls. We are faced with the difficulty of a ward layout with 13 side rooms with poor visibility but despite this challenge, we have achieved a 50% reduction in falls.
“We have developed effective strategies that are now embedded into our ward culture”
We have accomplished this by working closely with the Northern Devon Healthcare Trust falls lead to develop effective strategies that are now embedded into our ward culture.
For example, after handover for both day and night shifts we have a thorough safety briefing where we discuss patients at risk of falls. We then look to see if it is possible to move at-risk patients to higher visibility beds. We also tag team the bays at all hours so patients are never left unattended.
If a fall does occur we have a “post-fall huddle” with all ward nursing staff on shift and any other member of the multi-disciplinary team that would like to attend, such as the occupational therapist and the physiotherapist. We complete a post-falls checklist and we ask questions such as: “Why did this patient fall?”, “Where did they fall?”, ”Were there any contributory factors, such as footwear, confusion, staffing, patient independence etc?” and, crucially, “Could we have prevented this fall? If so, why didn’t we?”.
“What we learn from these huddles helps us to make simple changes”
We complete the huddle as close to the incident time as possible and it forms excellent team reflection. I, or the nurse in charge of the shift, then use the outcome of the huddle to engage the patient and discuss with relatives. What we learn from these huddles helps us to make simple changes to our daily working patterns to prevent similar falls from happening again.
The strategies that we have developed have had tremendous outcomes for our patients. In addition to the 50% fall reduction, we have also received excellent feedback from patients and relatives, who feel more relaxed and at ease knowing they can see someone in the bay at all times.
I feel very proud of how my team has embraced yet another challenge to reduce harm.
Gemma Lilley is ward sister on Lundy Ward, Northern Devon Healthcare Trust