Every patient interaction can help prevent an inpatient fall but it is important to ‘not just do ‘something’ to prevent falls but to do something that works’.
By focusing on one aspect of care each month for a year this project will bring falls prevention into everyday care for every patient not just for the high risk over 65’s as 23% of inpatient falls are under 65 .
5 key outcomes and implications of the project
• The goal of this campaign is to change the culture and the way we think about inpatient falls.
• By re-engaging the falls champions from the wards we saw how frontline staff could identify aspects of care that was missed and needed focused on rather than criteria dictated from a top down approach. This gave ownership back to the wards and compliance increasing. • By showing that if everyone who makes a little change in practice, we can bring about big changes for our patients.
• Education and daily discussion about falls bring it part of everyday care and not just for those identified as high risk.
• Ensuring that every interaction with patients has falls prevention in the mindset of every member of staff whether housekeeper, nurse, porter, AHP or Doctor.
The overall plan was to begin locally, within four inpatient areas and gradually expand to incorporate care of the elderly and surgery over a few months, however this went quicker than planned following the launch on social media #AprilFallsDay #LittleThingsMatter, with interest from the COTE and surgical ward teams and by week 2 the campaign was rolled out across the additional bed base.
By week 5 it was being adopted by oncology and other inpatient areas with interest being shown by other NHS Trusts.
Each month the campaign focuses on different areas that contribute towards falls and will continue for a year to include actions identified by the National Audit of Inpatient Falls and also aspect of care highlighted by the falls champions from the wards during the monthly meetings.
The aim is to show that it requires very little work to bring in change and reduce falls. Ward staff stated that they are too busy to add loads of work and large audits typically don’t bring in change, therefore we introduced a small weekly snapshot audit, based on that months focus.
Correlating this data alongside the trust’s falls data we can see how each week the trust was performing. Through regular reporting of the #LittleThingsMatter compliance audit to the Matrons they can have reassurance that the staff are meeting the needs of patients. For the trust board we had to show that through the ‘little things matter’ campaign we could reduce falls and hence save money.
NHSI (2017) Supporting this programme and providing valuable teaching for the falls champions are the clinical Specialist Physiotherapists as part of the Falls Assessment and Education Service.