Patients of PA Hospital are less likely to experience the domino effect of negative health outcomes associated with falling thanks to the commitment and collaboration of multidisciplinary teams supported by the hospital’s Falls Prevention Advisory Committee.
Committee Chair and Assistant Director of Nursing Adriana Hada says falls risk isn’t limited to the elderly, although it is true patients in this age bracket are at increased risk.
“We treat all inpatients as vulnerable because apart from advancing age, there are many other factors that increase the risk of falling,” said Ms Hada, citing medical conditions, medication usage, impaired mobility and gait, nutrient deficiencies, impaired cognition, and visual impairments as contributors.
“Often patients are disorientated when they wake up in hospital too so they may trip in their new and unfamiliar surroundings.”
Ms Hada says repeat episodes of falling are common.
“If you have fallen previously, you are at high risk of falling again. That is something we tell all our patients.”
Ms Hada says falls prevention is critical, because effects can be long-lasting and potentially deadly.
“The cost of injury associated with falls such as fractures or intracranial bleeding is quite high. The patient may never get back to their previous function, and sometimes they may even die,” she said.
“Even if a patient doesn’t have a fracture or injury after the fall, often the psychological impacts related to fear of falling makes them less likely to mobilise, and this can compromise their ongoing recovery.”
Ms Hada says several prevention initiatives are helping to reduce falls at PAH.
“Every patient has a falls risk assessment done on admission, and a plan of care is activated and tailored around the identified risks factors so we can manage them accordingly.
“In the bedside handover we also involve the patients so they can discuss what the plan is to minimise their falls risk.”
Other practical measures Ms Hada says the hospital has in place include having posters in all the bathrooms reminding patients to call for the nurse to ask for assistance when needed, reducing clutter in patients’ rooms, placing belongings and call bells within reach, ensuring appropriate footwear, ensuring nutrition and hydration, and changing the toilet seats from white to black across the whole hospital.
“We found some of the patients couldn’t see them, and that was contributing to accidents.”
Ms Hada says the Committee’s work in future will extend in scope to include more falls education and follow-up in the community post discharge.
“The aim is to give patients falls reduction strategies and educational materials before they leave the hospital. Information will include how they should continue exercising, what type of footwear is safe to wear, and how they should alter their environment at home to reduce their tripping risk on furniture and other obstacles. We have also started working with GPs to help us follow up with patients more effectively after discharge.”
Ms Hada says inter-departmental and patient collaboration is necessary to reduce falls at PA Hospital and ongoing efforts will always be needed to keep patients safe off the ground.
“We think it is important that patients drive their own plan of care both in hospital and in preparation for discharge, so our Occupational Therapy Department is coordinating interviews with patients and their families to determine how we health practitioners can best work with them to prevent falls” she said.
“Falls can affect people in many ways so working together across departments and with patients to minimise the risk is critical for ensuring positive health outcomes for patients during and following their hospital stay.”