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Should falls be a “never event”? Or are some falls inevitable?

  • Comments (36)

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

What do you think?

  • What measures have you introduced in your clinical area to reduce falls?
  • Are some falls inevitable?
  • Can falls prevention measures have a negative impact on rehabilitation?
  • Do falls risk assessments change how care is delivered?
  • Comments (36)

Readers' comments (36)

  • Anonymous

    Does a care-plan stop someone falling? Is everyone (inside and outside of hospitals) at risk of falling over? Do we know how many people fall at home?

    Rather than asking if a fall is 'inevitable' would it be more realistic to say 'unavoidable'.

    If you want to call a fall inevitable do you think it could ever be caused by non-compliance with meds, not using walking aids, not wearing supportive wearing footwear, not following therapists advice?

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  • Anonymous

    A never event? - how? keeping people tied to the bed, never letting them walk about?

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  • Anonymous

    I am tired of these attitudes towards those of a certain age. I am 66 and still carry out all the same activities with the same level of physical fitness and cognitive ability that i did when I was 50 which includes many sporting events and I have friends of ages up to their mid-80s who ski and climb mountains literally and metaphorically as well as going on up to 8 and a half hour hikes in the mountains in the summer which are not for the faint hearted.
    How will everybody cope when this age group make up more and more of the juvenile workforce?

    look after your elderly patients as they deserve with respect and without patronising them and treating them as complete senile idiots!

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  • Anonymous

    what about post-op patients who often feel dizzy when they first get up, or those who are under the influence of drugs or alcohol, everyone can fall.

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  • Anonymous

    Anonymous | 18-Jun-2013 8:15 am

    they need to be advised pre-op and then again post op and need to be adequately supervised. barriers can be used if they are in danger.

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  • Anonymous

    'Never Events' are clearly not things which can never happen - of course some people will fall.

    The suicide in hospital one is philosophically interesting, as suicide isn't illegal and recent court ruling support the right of people to commit suicide by starving themselves - Anonymous | 17-Jun-2013 7:50 pm summed it up with "look after your elderly patients as they deserve with respect and without patronising them"

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  • michael stone

    Anonymous | 18-Jun-2013 3:29 pm

    Hmnn - the judge's comment that if Tony N refused food and drink, then his cliniicans could have provided sedation and other palliation, seems to me to prove that something is rotten in our society !

    Anonymous | 17-Jun-2013 7:50 pm

    I'm with you. Treat patients with respect, don't patronise them, think how you would like it if you were the patient - etc.

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  • Anonymous

    Excellent point Eileen - it feels as though NICE are being completely unrealistic by trying to make falls a "never event".

    As Anonymous 17 June 7.09pm points out, to stop all falls would mean depriving people of their liberties purely because they fall in to what the government etc deem as "high risk categories".

    What about individual, patient-centred, care plans?
    What happened to trusting nurses to make judgments based on their clinical experience and training to decide what level of fall prevention is appropriate?

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  • tinkerbell

    one of our staff once told a patient to 'sit down, you might fall over' to which i replied 'oh give her a chance to stand up first'.

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  • Anonymous

    the under-65's fall over too, I fell over once in hospital and hurted my nose.

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