Abstract

Falls are common across older populations and in particular for people who have life- limiting illnesses. Our organisation wanted to reduce the risk of falls and minimise harm to patients whilst promoting independence, dignity and enablement across our in-patient unit and day therapy services. We felt the most effective way to implement multifactorial assessment and intervention recommended by NICE would be to adopt and utilise a hospice wide multi-disciplinary approach in line with an enabling and rehabilitative focus.

The ultimate aim of the project was to reduce the incidence of falls by promoting decision making and staff autonomy, equipping staff with skills, knowledge and tools to promote patient safety, dignity choice and independence. A key part of this was increasing the confidence of staff in the identification of appropriate falls interventions, taking into account individual patient preferences.

In 2016 a multi-disciplinary falls working party was established. The working party have regularly audited falls and documentation, linked with community services, developed documentation and care plans, updated knowledge, training and policy, and collaborated with internal teams. Currently a falls documentation audit is taking place.

The joint development and introduction of documentation has been a success, addressing concerns raised by staff and providing them with the tools needed to practically promote choice and independence. Since the introduction of the falls working party there has been a considerable increase in communication regarding falls and collaborative working as well as a reduction in number of falls and level of harm obtained from falls over the last three years. A large proportion of falls have been identified as unavoidable as part of the audit work undertaken, but staff have been more pro-active in managing falls and maintaining levels of patient independence and are reporting increased levels of confidence in promoting patient choice whilst maintaining autonomy.