Fall back position.

I’ve pulled this out of ‘The Nursing Times’ although it’s a Press Association piece. The National Institute for Clinical Exellence (NICE) who set guidelines for good practise are worried about the number of people who fall over in hospital – that is, those people who come in for treatment but then fall over and end up worse off than when they came in. Unfortunately they have got it all the wrong way round;

“Between the beginning of October 2011 and the end of September 2012, there were more than 200,000 falls report in English hospitals.

Although the vast majority of falls (97%) saw no or low harm, such as minor cuts and bruises, around 900 patients did suffer extreme harm, including head injuries and hip fractures. Figures show that 90 patients actually died as a result of their falls.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: “Falling over is a serious problem in hospitals, and unfortunately their likelihood increases with age as people become frailer. They can cause distress, pain, injury, a loss of confidence and independence, and in some cases, death.

“While it would be virtually impossible to prevent all hospital falls from happening, our guideline calls for doctors and nurses to address the issues that will reduce the risk of their patients suffering avoidable harm. No two patients are the same and so a “one size fits all” approach will not work.”

All patients aged 65 years and older, as well as those over 50 who have dementia, stroke, vision or hearing problems and other underlying conditions, should be considered as high risk of falling while in the care of a doctor or nurse, according to the new guidelines.

NICE guidelines suggest that doctors and nurses should asses each patient’s risk of falling, paying attention to factors such as:

if they have fallen previously;

what medicines they are taking; and if the patient has poor eyesight or problems with balance or with walking.

This assessment could help care givers reduce the risk of a patient falling over, by changing medication, or simple steps such as accompanying them to the lavatory or providing them with alternative footwear.”

It’s all the wrong way round because it assumes that patients are all right until they are assessed as at risk. As a result one ‘good idea’ I’ve seen suggested is to put red socks on those at risk of falling.

In fact most people in hospital are at risk of falling and everyone should be considered at risk until there is an assessment giving them the all clear – ‘not at risk’. Then those patients can be given a sign that you don’t need to pay so much attention – blue socks, perhaps.

The point is that fall prevention should be the fall back position for everyone until its clear there is no risk.

That creates a culture of care, not an assumption that you don’t have to bother unless a risk is spotted.

Of course, you may well need more staff….

Neil Harris

(a don’t stop till you drop production)

Home:       helpmesortoutthenhs.blogspot.com