abcdefalls reminder presentation- mf - bmj blogs€¦ · housekeeping “someone should check the...
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ABCDEFalls ReminderMatthew ForbesFoundation Year 2
Why?
Falls account for
30% of patient
safety incidents
reported to the
NRLS
Falls cost the NHS £15 million annually
Many falls are
unacceptable and
preventable by
modifying behavioural
or environmental
factors
HousekeepingHousekeeping
“Someone should check the floors every half an hour”“Someone should check the floors every half an hour”
“If someone is incontinent on the floor clean it up immediately”“If someone is incontinent on the floor clean it up immediately”
“Make sure clutter is removed from around the bed”“Make sure clutter is removed from around the bed”
Ward organisationWard organisation
“Ensure patients who are at high risk are placed near the nurses station”“Ensure patients who are at high risk are placed near the nurses station”
“Planning staffing around when people are more likely to fall”“Planning staffing around when people are more likely to fall”
“Staff being more aware of where patients are and what they are doing”“Staff being more aware of where patients are and what they are doing”
BBBBBBBB
CommunicationCommunication
“Make sure the patient knows how to ask for help e.g. to go to the toilet”“Make sure the patient knows how to ask for help e.g. to go to the toilet”
“Take a step back and educate people when they are younger about falls”“Take a step back and educate people when they are younger about falls”
“Treat patients as individuals”“Treat patients as individuals”
Some of the
interventions
suggested by
our
interviewees
Some of the
interventions
suggested by
our
interviewees
EquipmentEquipment
“Make sure alarm bells are within patients’ reach”“Make sure alarm bells are within patients’ reach”
“Adjustable height seating with built in pressure relief”“Adjustable height seating with built in pressure relief”
“Individualised seating”“Individualised seating”
“Make sure patients with catheters have leg bags”“Make sure patients with catheters have leg bags”
“Avoid unnecessary catheters”“Avoid unnecessary catheters”
“Custom lengths of catheters”“Custom lengths of catheters”
“Less slippery footwear”“Less slippery footwear”
“Elasticated or better fitting pyjamas”“Elasticated or better fitting pyjamas”
“Mend any broken glasses”“Mend any broken glasses”
“Ensure patients have their glasses”“Ensure patients have their glasses”
CCCCCCCCDDDDDDDDEEEEEEEE
AAAAAAAA
Brice S, Long S, Forbes M, Shanley R, Vincent C, Woloshynowych M. Identifying risks to older patients – a scoping exercise. A report for the Dunhill Medical Trust. 2009.
Assessment and care planningAssessment and care planning
“One to one care if delirious”“One to one care if delirious”
“Continence assessments”“Continence assessments”
“Referring to OT and physio quickly”“Referring to OT and physio quickly”
“Better collateral history”“Better collateral history”
“Thinking more about the needs of the individual”“Thinking more about the needs of the individual”
Ward environmentWard environment
“Ensure patient’s aids have name labels”“Ensure patient’s aids have name labels”
“Lighting the floor to reduce glare”“Lighting the floor to reduce glare”
“Better lighting”“Better lighting”
“Signage pointing the route to the toilet”“Signage pointing the route to the toilet”
What?
AAAA larm bell
BBBBed location
CCCCatheter
DDDDress
EEEEyewear
Falls Reminder
ABCDEFalls reminder
Eyewear
Dress
Catheter
Bed location
Alarm bell
Item
If the patient is mobile and has a
catheter have you considered giving
them a leg bag?
Does the patient have poor
eyesight? Do they have their
glasses with them and are they
easily accessible to them? Are they
in working order?
Do they have appropriate fitting
pyjamas/nightgowns? Do they have
appropriate fitting footwear?
Have you thought about the best
location for the patient on the ward?
Should they be moved nearer to the
nursing station?
Does the patient know how to ask
for help? Do they have a call bell;
know where it is and how to use it?
Considerations
How?
Engagement
Falls reminder
Feedback
ABCDE
Strategyfor
change
Assess impact
Outcomes
This is a cost effective
addition to existing care
processes and
interventions, whose
benefits far outweigh
the extra time required
and cost
Acknowledgements
• Susy Long & Sarah Brice, Centre for Patient Safety and Service Quality, Imperial College London
• David Morrow- Illustrations
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