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Care plans should include fall prevention, says NICE

  • 15 Comments

All hospital patients aged over 65 should be considered to be at high risk of falling and have an appropriate care plan drawn up, according to guidance from the National Institute for Health and Care Excellence.

This also applies to all patients aged 50 and above who have dementia, stroke, vision or hearing problems and other underlying conditions.

NICE said nurses and doctors should identify the individual risks of these patients to help reduce serious injury and death. For example, whether they had fallen previously, what drugs they are taking, and whether they had poor eyesight or problems with balance or walking.

Clinicians should then create a tailored plan to reduce the risk of falls – for example, by adjusting medication, offering alternative footwear and helping patients go to the lavatory.

The new recommendations issued by NICE have been added to existing guidance, which focus on falls in community settings.

The NICE guidelines also advise clinicians to encourage patients to use their bedside calling system and to explain to friends and relatives when and how bed rails might be adjusted.

Professor Mark Baker, director of NICE’s Centre for Clinical Practice, said: “While it would be virtually impossible to prevent all hospital falls from happening, our guideline calls for doctors and nurses to address the issues that will reduce the risk of their patients suffering avoidable harm.

“No two patients are the same and so a ‘one size fits all’ approach will not work,” he added.

Professor Damien Longson, a consultant psychiatrist who chaired the expert group that developed the new NICE recommendations, said: “Many patients who need extra support in carrying out simple tasks, such as reaching to get a drink or going to the bathroom, do not wish to make a fuss or to be seen as a burden to hospital staff.

“The NICE guideline advises doctors and nurses to reassure their patients that it is ok for them to press the call button, and that they are there to help them if needed,” he said.

Meanwhile, Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “We were pleased to contribute to this important guidance. Falls in hospital can make an already distressing time even more difficult for vulnerable patients, and any advice and support which helps reduce these incidents is good news for staff and patients.”

 

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  • 15 Comments

Readers' comments (15)

  • our care-plans already have a falls assessment section, they have done for years.

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  • So does this Trust and also had them for years. What interests me more though is that I was talking with an HCA yesterday and she is really upset with the system. She has nursed for years and always spends time with the patients combing their hair, cleaning nails, pampering them and making them feel generally valued. Now, with all the extra paperwork she has to spend less time with the patients to ensure that the paperwork is all done. It is ridiculous and getting worse is her general feeliing and I have to agree.

    Let people care for patients without worrying about lawsuits

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  • desertdeserter | 12-Jun-2013 12:20 pm

    Now, with all the extra paperwork she has to spend less time with the patients to ensure that the paperwork is all done. It is ridiculous and getting worse is her general feeliing and I have to agree.

    Let people care for patients without worrying about lawsuits

    This is a fundamental problem with the NHS today. There is now so much paperwork associated with each patient
    you often don't get chance to read it whilst that patient is in your care and you end up staying after your shift to document your own patient notes.

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  • "There is now so much paperwork associated with each patient
    you often don't get chance to read it whilst that patient is in your care..."

    it sounds as if patients are a real liability in the NHS. Do they require a passport and tickets as well?

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  • The above shows the result of knee-jerk responses to criticisms about failure in the system. Compassionate care was the mantra and yet the responses are about records and paper tasks. The HCA's were seen as patient friendly in previous patient surveys. Qualified nurses were seen as detached and too bust with tasks not directly related to patient contact/care. If HCA's join the paper chase then we are headed for more problems. Have always suspected HCA's have ben made the fall guys but they should hold their ground and continue caring.

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  • Let's not turn this into another pointless and destructive 'qualified nurses don't care/HCAs do care' fight.

    With regard to the subject of the article, I agree with the first comment. Risk/Falls assessments have been carried out with appropriate care planning for years.

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  • Sick old people are likely to fall.

    Solution ----one to one care!

    Cannot provide that?

    Then accept old people WILL fall !

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  • Anonymous | 12-Jun-2013 1:40 pm

    "There is now so much paperwork associated with each patient
    you often don't get chance to read it whilst that patient is in your care..."

    it sounds as if patients are a real liability in the NHS. Do they require a passport and tickets as well?


    The point I was making is that a patient is often cared for following a brief handover. For basic care such as risk of falls, skin care, fluid and dietary intake an assessment is made on the hoof as it were as patient care takes priority over pouring over notes. I was not saying patients are a liability but too much paperwork is.

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  • Anonymous | 12-Jun-2013 6:59 pm

    mine was a general and facetious comment with no personal offence intended. it was just suggesting that the paperwork in the NHS is overtaking patient care and they are getting in the way of it rather than the other way round as it obviously should be.

    It is just my European roguish sense of humour. Daft comments are sometimes help to lighten the mood.

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  • Anonymous | 12-Jun-2013 8:04 pm

    should have read 'can sometimes help...'

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