Action needed to reduce hospital falls

HOSPITAL doctors and nurses should identify patients at high risk of falling to reduce serious injury and death, says new NICE guidelines.

Over 200,000 falls were reported in hospitals in England between October 2011 and September 2012. Most of these patients (97 per cent) suffered little more than minor cuts and bruises, but 90 patients died because of their falls and around 900 patients experienced severe harm, such as hip fractures and head injuries.

NICE is advising hospital nurses and doctors to consider the high risk of falling in all patients aged 65 years and older, as well as all patients aged 50 and above who have dementia, stroke, vision or hearing problems and other underlying conditions. Other factors to consider include have they fallen previously, what medicines they are taking, do they have poor eyesight, problems with balance or with walking.

Doctors and nurses are advised to use these details to create a plan that will reduce each patient's chances of falling while in their care; for example by adjusting their medication, offering alternative footwear and helping them go to the lavatory. The new recommendations have been added to existing guidance from NICE advising on falls in the community (i.e. at home or in residential care settings).

NICE advises doctors and nurses to encourage their 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 the Centre for Clinical Practice at NICE said: “Falling over is a serious problem in hospitals, and unfortunately their likelihood increases with age as people become frailer. They can cause distress, pain, injury, a loss of confidence and independence, and in some cases, death.

“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.”

The updated clinical guideline are available at: www.nice.org.uk/CG161 

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