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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