A Quality Improvement Project on Falls prevention in patients aged over 65 admitted under the surgical team

Title: A quality improvement project on falls prevention in patients admitted under the surgical team.

Modifiable and non-modifiable factors contribute to falls in older people. Our aim was to examine prevalence of risk factors for falls in patients >65 admitted under the surgical team and prevent readmittance through signposting to falls clinic.

The first cycle of this QIP involved a review of all sets of charts for patients >65 (n=12) admitted under the surgical team with fall-related injuries between Dec 2022- April 2023.

Parameters examined included whether an electrocardiogram (ECG), CT Brain and Lying/ Standing blood pressure (LSBP) was performed, or polypharmacy (>5 medications) was evident. We then delivered a presentation to the surgical team and signposted to the local falls service.

The second cycle involved examining the same data for the month of August 2023.  The second intervention involved highlighting the project to the surgical ward manager and encouraging ECG/ LSBP assessment.

In Cycle one, 3/12 (25%) of patients represented with falls.  4/12 (33.3%) of patients had an ECG and 11/12. Only 1/12 (8.33%) had their LSBP checked.  8/12 (75%) patients demonstrated polypharmacy, with no evidence of medication optimisation.

In Cycle 2, 5 sets of notes were reviewed. 4/5 (80%) had an ECG and 5/5, and only 1/5 (20%) had their LSBP included. 3/5 patients (60%) demonstrated polypharmacy and one patient (20%) was referred to falls clinic.  

In Cycle 3, 7 patients were admitted with falls. 3/7 had an ECG, 2 of which showed arrythmia . 7/7 had a CT brain and 0/7 had LSBP performed. 5/7 demonstrated polypharmacy and one patient was referred to falls clinic. One patient was readmitted with falls under surgeons and was not referred to falls clinic.

This project identifies modifiable falls risk factors in patients admitted under the surgical team following falls, highlighting the need for specialist geriatric input.