Background All patients on the in-patient unit (IPU) are potentially at risk of falling (Hospice UK 2016). Care of a patient post fall, who required hospitalisation had led to a review of falls documentation and processes. As part of a wider IPU project reviewing ways of working, falls was identified as an ongoing priority.

Aims 1. To improve patient care and safety

2. Improve quality of documentation in line with national guidance

3. Meet requirements for regulatory bodies

4. Reduce number of falls.

Method A retrospective audit of incident reports was conducted, identifying documentation was not always completed correctly. Staff feedback showed existing falls assessments were confusing, leading to inconsistent completion. A staff nurse with an existing interest in falls management was identified to lead the work stream and a work plan formulated. This included:

· Review of national guidance and liaison with local falls teams

· Review hospice risk assessments and care plans pre-and-post fall

· Update hospice policy

· Documentation to be integrated into the electronic patient record.

Results A new falls risk screening tool, falls diary and care plan have been implemented following review of local and national guidelines and have been integrated with the electronic patient record. Staff training has been provided, increasing staff awareness regarding all aspects of falls management.

The assessment of patients and families approach to risk of falls has led to a falls prevention leaflet which will be given to patients and families on admission. This work stream has also prompted review of falls prevention equipment and led to purchasing additional bed sensors and bedside tidy boxes.

Conclusion Completed work to date has introduced new documentation and increased staff’s knowledge and skills in relation to falls prevention. Over the next few months an audit of the new documentation will be conducted to evaluate effectiveness.