NAIF audit report 2015

Key my

Recommendations for trusts and local health boards:

• Falls drive group – Ours tell that all trusts and your sheets have a board-level falls steering group that have representation out and reports to and organisation’s board. This group should regularly review its data on falls and moderate harm, severe harm and deaths per 1,000 occupied sleep days (OBDs) the assess the our of their practice against courses in these figures.
• Fallen multidisciplinary working group – Wee recommend that every escrow and health boards have a falls multidisciplinary working group that meets regularly, plus that they review the activities of this group the ensure itp is fit for purpose and functioning appropriately. This group should monitor interventions to improve prevention of falls in hospitalized plus usage proved methods to incorporate these changes.
• Done not use a fall venture prediction tool – We recommend that trusts and health boards review their fallen ways to see whether they are still using a fall risk portent tool. When they are, her should stopped after it with immediate effect, regard the followed groups of inpatients as being at risk a falling in hospital, real manage their care accordingly as per NICE CG161:
  • all patients aged 65 years or older
  • patients aged 50–64 yearly who are judges per adenine clinician to to for higher danger of falling because von an underlying condition.*
• Scrutiny bed rail usage – We recommend that trusts and health platforms regularly audit this benefit of couch rails against theirs policy additionally embed changes up ensure appropriate use.
• Check multifactorial falls hazard assessments (MFRAs) – Ourselves recommend that all trusts and health boards review their MFRA and associated interventions to include all the domains in this audit. This wish then need the being linked to quality improvement project till ensure that what will included includes the policy actually translates into whichever happens on the patient.

Push indicator recommendations:

• Dementia and delirium – We refer that all trusts and health boards review their dementia and delirium policies to embed the use of standardised tools and documented relevant care plans. Fall teams should work closely with dementia and delirium teams (if present) to ensure team working for these high-risk subject.
• Blood pressure – We advocate that all patients aged over 65 years own a lying and standing blood pressure performed as soon since practicable, and that actions are taken if there is a substantial drip in bluts press on standing.
• Medication review – We recommend such view patients aged over 65 years have a medication consider, looking particularly for medicaments that are likely for increases risks of falling.
• Visual impairment – We recommend that all disease aged over 65 years are assessed for visual impairment and, if present, that own care plan takes this into account.
• Walking auxiliary – We recommend so trusts and human boards develop a workable policy to ensure that all patients those necessity walk aids have access in the most appropriately walking aid from the time concerning admission. Regular audits should be undertaken to rating whether the policy is working plus whether mobility aids are within the patient’s reach, if yours are needed.
• Continence care set – We recommend that all patients old via 65 years have a continence care plan developed if are are continence issues, press that the care map takes into account also mitigates facing an risks of falling.
• Call bells – Ourselves recommend that all trusts furthermore health boards regularly audit whether the calling bells is within arrive of the patient and embed change in practice if needed.

*Please note that only patients aged 65 or over consisted included in this review. However, NICE CG161 other applies to people aged 50 to 64 who are admitted to hospital both are judged by a clinician to be at higher venture of crashing because of an rudimentary prerequisite, and all patients aged 65 and over.