Nurse Led Inpatient Falls Prevention Programme
Falls are the leading cause of injury in those over 65 years of age. Research would suggest that one third of people over the age of 65, and one half over the age of 80 have had a fall in the last year. One tenth of these have had multiple falls requiring hospitalization. Sadly, the risk of falling increases with age, as does the complications from falls. Falls are a leading cause of hospitalization for the elderly and 7% of falls result in injuries, lacerations, haematomas, soft tissue injuries, brain injury and non-hip fractures, with another 3% of falls resulting in hip fractures (Fan and Cunningham, 2003).
Consequences of hip fractures can be very severe, 20-25% of elderly people with hip fractures die within six months of sustaining a hip fracture; 50% sustain a loss of independence; and less than 30% regain their former level of mobility. Falls by those aged 65+ are the leading cause of hospitalization and accounts for approximately 45% of attendances to Accident and Emergency departments (Kenny and Richardson, 2001).
A Nurse Led Inpatient Falls Prevention Programme was developed under the stewardship of Dr Conal Cunningham, Professor J. Bernard Walsh and Dr Miriam Casey to integrate inpatient and out-patient services for falls and fracture prevention – the first of its kind in Ireland. The service was created due to an increasing recognition that falls and fractures, while a considerable cause of morbidity for older people and associated with significant resource utilisation, are frequently preventable. The in-patient prevention program was designed for patients who fall or are at high risk of falling, and as a result, are targeted for extra assessment and intervention by a team of clinical nurse specialists.
Patients are assessed for falls risk using the Falls Risk Assessment Tool at ward level and those deemed at a high risk of falling are identified with an ID bracelet, bedside notification and are also offered External Hip Protectors, as part of a multidisciplinary approach to reduce or eliminate falls risk factors. The role of the Clinical Nurse Specialist also includes an educational program for ongoing staff training in falls prevention and a regular in-patient audit program which evaluates the effectiveness of our service and the falls program.