Abstract
Introduction: Inpatient falls present a significant safety concern in NHS hospitals, with approximately 247,000 inpatient falls per year in England alone (Healthcare Quality Improvement Partnership (2023), National Audit of Inpatient Falls 2022). The actions following an inpatient fall have potential to influence clinical outcomes and patient safety. This quality improvement project aimed to enhance patient safety by improving the accuracy of post-fall review documentation and increase awareness of the Trust's post-fall protocol.
Methods: Data collection involved reviewing electronic notes of patients across three Senior Health wards who experienced inpatient falls during two cycles: 01/06/23 – 31/10/23 (N=12) and 01/11/2023 - 29/02/2024 (N=25). Additionally, surveys were conducted among Senior Health medical staff to gauge awareness of post-fall protocols and documentation. Interventions, in the form of teaching sessions and a poster circulated within the department, aimed to improve awareness of post-fall protocol and documentation. Statistical analysis was conducted using unpaired t-test.
Results: Statistically significant improvement was observed in the use of post-fall review proformas between audit cycles, increasing from 33% to 70% (p<0.05). Although awareness of the post-fall proforma improved from 63% to 80%, this change was not statistically significant.
Conclusion: The intervention significantly enhanced the accuracy of inpatient post-fall documentation, evidenced by the increased use of post-fall review proformas. The circulation of the 'Inpatient Post-fall Review' poster contributed to this improvement by outlining recommended timeframes for review and steps for accessing post-fall review proformas. While awareness of the hospital's post-fall protocol did not significantly improve, the increased completion rate of post-fall proformas indicates a commitment to thorough assessment and documentation among Senior Health medical professionals. However, despite awareness of the existence of the post-fall proforma, some professionals may not utilize it for documentation, potentially explaining the lack of significant difference in awareness across cycles but an improvement in proforma usage post-intervention.