Can a multi-factorial assessment and interventional programme decrease inpatient falls in an elderly care ward?

Area of Science:

• Geriatric Medicine
• Patient Safety
• Healthcare Quality Improvement

Background:

• Inpatient falls are a significant safety concern, with approximately 282,000 reported annually in the UK.
• Falls can lead to severe injury or death, but research indicates 18-31% reduction is possible with interventions.
• Effective post-fall management is crucial for patient recovery and preventing subsequent falls.

Purpose of the Study:

• To decrease the inpatient falls rate in an Elderly Care ward by 20% using a multi-factorial approach.
• To enhance the quality of post-fall care provided to elderly patients.
• To implement and evaluate the effectiveness of a care plan, staff incentive, and post-fall guidelines.

Main Methods:

• A baseline audit established the falls rate (14.70 falls/1000 bed days) over one year (Nov 2010-Oct 2011).
• Interventions included a patient care plan, a 'walking-stick' incentive poster for staff, and post-fall guidelines.
• Plan-Do-Study-Act cycles were used, with feedback sessions, compliance monitoring (care plan completion), and re-audits.

Main Results:

• The inpatient falls rate decreased by 15.4% to 12.44 falls/1000 bed days one year post-intervention (Nov 2011-Oct 2012).
• Care plan compliance reached 89%, identifying up to 81% of patients as high-risk.
• Staff feedback on interventions was positive, supporting ongoing implementation.

Conclusions:

• A multi-factorial approach, including care plans and staff incentives, can significantly reduce inpatient falls.
• The study achieved a 15.4% reduction in falls, demonstrating the effectiveness of the implemented strategies.
• Continuous monitoring and re-auditing are necessary to achieve the initial 20% reduction goal.