3083 Improving post-fall care for inpatients at North Middlesex University Hospital

Abstract

Aim We aimed to improve the assessment, documentation, and management of inpatient falls by introducing a memorable CARE poster and promoting the use of a digital falls proforma for both nurses and doctors. This initiative aims to standardise practices and enhance patient safety. Method Cycle 1: Initial data revealed poor documentation of falls, with missing elements such as Clinical Frailty Scale (CFS) scoring, medication review, pain management, and lying/standing blood pressure (LSBP) measurement. These critical aspects were incorporated into the CARE poster. Cycle 2: The CARE poster and digital falls proforma were launched, accompanied by brief training sessions on the geriatric ward. These sessions encouraged resident doctors to prescribe analgesia and supported comprehensive documentation. We audited falls documentation before and after the intervention to evaluate improvements in recording relevant data. For the next cycle, we aim to engage a broader audience, including all medical and surgical teams, by conducting face-to-face campaigns and distributing email reminders. The focus will be on ensuring doctors and nurses complete every section of the proforma. Conclusion The CARE poster and digital falls proforma have significantly improved falls documentation, ensuring the inclusion of critical elements like LSBP, blood sugar checks, and thorough physical examinations. It also highlights key management steps, such as requesting investigations, prescribing analgesia, and reducing polypharmacy. Our project demonstrated a 40% improvement in LSBP documentation and medication review. However, analgesia care improved by only 2%, despite 85% of post-fall patients sustaining injuries. Further education for doctors and nurses is needed to address this gap. Currently in its third cycle, this QIP continues to evolve, with ongoing implementation and a planned audit. We are optimistic that it will enhance clinical practice and uphold our trust’s core value: putting the patient first.