Background Falls management and prevention is a top priority in all healthcare settings (National Institute for Health and Care Excellence, 2019). Research suggests that some nursing staff lack confidence when making clinical decisions regarding the appropriate level of falls supervision. Observational assessment tools exist to support the assessment of patients in acute hospital trusts (Richardson, Dawson, Henderson, et al. Age Ageing. 2019; 48:(S2): ii1–ii10), but currently no falls observational tools exist for hospice settings.

Aims To develop an observational falls assessment tool, to support nurses’ clinical decision making, for use in a hospice setting.

Methods Our multidisciplinary falls group was developed with an aim to reduce falls in the hospice setting. The group peer-reviewed an existing observational falls assessment tool which was designed for use in the acute setting to consider how the tool would translate into a hospice inpatient setting. We retrospectively reviewed contributing factors for reported inpatient falls at our hospice, and using this data we developed the FEWS (Falls Early Warning Score) chart; a more comprehensive assessment tool to assess palliative patients’ risk of falls in a hospice setting. This tool considers important risk factors such as fatigue and breathlessness, environment, medical deterioration and patient compliance which our data showed to present significant risk of increasing falls amongst palliative patients.

Results Since the introduction of FEWs we have seen a significant decrease in the number of annual falls between 2021 (n=133) and 2022 (n=73). We now plan to carry out a project to further evaluate the adoption of FEWs in the hospice setting which we hope will create a change in the culture of how we think about falls in a hospice, shifting the focus to prevention rather than reaction.

Conclusions Developing a falls observation assessment tool to address the needs of patients with a life-limiting illness can reduce the incidence of falls. Further work will evaluate staff educational needs for better adoption of FEWs.