Abstract
Aims
This closed loop audit aims to primarily assess and improve the number of geriatric patients who fell on elderly wards in a District General Hospital using cost effective methods. The secondary aim is to improve documentation of falls and assess for contributing factors. Hypothesis The primary hypothesis is that number of falls can be reduced through better nursing training and co-locating high risk patients. The secondary hypothesis is that improvements in documentation can be made with nursing training specified to falls and to corroborate risk factors with existing literature.
Methods
The first cycle was conducted between February 2021 to May 2021. Patients who were deemed high risk of falls, defined as over 80 years with at least 1 previous fall, were co-located. Nursing staff were provided with falls related training and how to report falls. The audit was repeated between the months of February 2022 and May 2022 to prevent seasonal bias. Results collected using the computerised internal patient records and paper documents. The number of falls, in addition to demographics, comorbidities, medications and complications were collected and compared.
Results
It was shown that cost- effective measures implemented in this audit significantly reduced the number of falls- down from 50 to 29 total falls across the same time period. We showed polypharmacy is a contributing factor to increased falls, with anti- hypertensive medications recurring as a repeated offender. 90% of those who fell were recurrent fallers, highlighting the importance of early identification of those at high risk.
Conclusion and further studies
This audit has highlighted the importance of simple, clinically effective and cost- effective measures in falls prevention. Further improvements, such as falls alarm for patients and refurbishing of ward layouts have been suggested by nursing feedback. Once implemented, the wards can be re- audited for further falls prevention.