Fallsafe – Put the patient first. Preventing falls in Hospital.

she was living independently and she had
a car she used to go out she’s very sociable lady she travelled to Australia
she went to Mexico she went to Belize Guatemala she played bowls she worked on the canal as a volunteer she was just a very busy
lady enjoyed socializing enjoyed her grandchildren she had a party in the June
with all her friends to celebrate her birthday and then the fall happened
in July August time falls will never go away and we will never get the falls rate in Hospital down to zero but what we are striving to achieve is preventing
the harm that occurs to patients The purpose is to try and reduce the Falls
with harm so that’s falls where patients end up with fractures as a result or
indeed some sort of head injury She was admitted to hospital and then on the
second night that she was in we got a phone call we just got home to be told that
she just fallen out of bed and she’d broken her clavicle and they thought her
hip my sister and I are both nurses so we know the impact that that could
have on her but you know we thought well you know she’ll have the surgery and
then a bit of recuperation and then
hopefully go back home Fallsafe is
really important because it helps us to keep our patients safe it decreases
workload for the staff and it’s a very simple easy way of working. There
are 10 steps to Fallsafe we use in the trust to help break down the elements of
Fallsafe for the staff to be able to implement on an easy basis so using
either one at a time or a collective two or three to implement on their ward She had very bad post-op confusion and delirium so she stayed in hospital for
at least four weeks and then it was decided we that she wasn’t perhaps safe
to go home at that point so we suggested perhaps a convalescent home for a couple
of weeks just to give her a bit of time and then go back to her flat every adult
inpatient who comes into the OUH Trust we would risk assess for falls,
develop a specific care plan for that particular patient and look to see which
equipment would be best suited for that individual. People don’t always realize
that a lot of what they do in terms of fall prevention is Fallsafe and it is
all included as part of Fallsafe so simple things like giving patients
call bells which are accessible at the beds making sure that people have got safe
Footwear on their feet whether that be their own Footwear or whether it be the
double-sided grip socks that we supply in the Trust now for patients. Medication
is very important in falls and at least a quarter and possibly a half of all
falls are due to medication and this is one of two things usually either the
medications are causing sedation and the patient’s balance is impaired as a
result of having their senses dulled or more commonly it’s causing orthostatic
hypotension or postural hypotension so their blood pressure drops when they
stand up As soon as a patient is admitted to the ward it’s really
important to do all the risk assessments because the likelihood of somebody being
agitated ill wanting to get out of bed will happen very soon after they’ve
arrived. It’s about putting patients in the right place – so somewhere whether
they can be observed from the nurses desk or that there’s a Baywatch
arrangement so that there’s somebody in that bay I think the ways to overcome
the issues with following the Fallsafe bundle is by educating the junior
members of staff to ensure that they are competent and confident to follow the
Fallsafe bundle it’s a clear structure it’s a clear guideline it is
evidence-based so it guides you through to what you need to do to reduce the
impact of that fall to that patient most of the patients which we who we get in
acute hospital especially in medicine are having dementia or they’re confused
and sometimes they forget to use the call bell and if they need a toilet or
if they need a glass of water they tend to stand up and if we don’t let adhere to the
Fallsafe bundle they they are going to fall and they’re going to have harm from
that fall. Mum didn’t ever go home after that
she went to the convalescence home and she lasted at one night there and they
called my sister I was away on holiday they called my sister and said that they
couldn’t cope she was very muddled she was walking around at night so her
confusion continued she wasn’t safe to go home she then got more and more
muddled she was then assessed and she was
diagnosed with Alzheimer’s from that and yeah she’s still we’re now just over a
year on and we’ve sold her flat she doesn’t have a car anymore she’s in a
care home and she won’t go home now Implementing Fallsafe should be
everybody’s business everybody should be included it doesn’t matter who you are
or where you are if you see somebody who’s struggling down the corridor you
should be prepared to help them if somebody’s visiting your ward you should
be there to help them if it’s a patient or a colleague on your ward and an
incident occurs we should all be there to help them the more eyes and ears we
have looking for those potential at risk patients the better I think that this is
a role for everyone who works on the ward not just the doctors and the nurses
obviously the therapists the OT’s and the physios but there’s a great contribution
from the domestic staff the cleaning staff the porters who come on and off
the ward very often they’ll be walking across the ward and there’s a patient
getting up in the corner and their response shouldn’t be to go and get the
nurse but actually to go and see that the patients all right before they fall
over As physios and OT’s we work with the patients at the time of the fracture or
the time of the injury and right through until full recovery basically we all
have a role to play in prevention of Falls in hospital and if we’re vigilant
and we’re aware and we take action then we will all contribute to reducing the
number of Falls We need to prevent harm and through doing these processes which
includes a proper risk assessment and a timely way implementing measures whereby
patients are safeguarded from their falling or from any harm really will
make a difference to their stay A for them and the
quality of care and also for the staff in terms of managing them It’s huge
guilt that she’s in a care home you do question whether you’re doing the right
thing she seems very settled so I think that’s all that we can hope now is that
she’s settled she still knows who we all are at the moment so that’s really nice
and yeah that’s probably the best we can hope for is that she’s relatively happy
and settled if you take anything take onboard the impact it can have on that
individual and the rest of the family it’s so important to do those assessments on
them and if there are risks at all then act on them and it’s very easy to do the
risk assessment and perhaps we don’t always follow it through just remember
and put the patient first

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