Background: Patient falls are a significant problem and one of the most common adverse events experienced in hospitals; with the impact of falls on patients and the added costs to the healthcare system of great significance. Falls are considered an indicator of the quality of nursing care which requires uncompromising attention and has been recognized by the Australian Commission on Safety and Quality in Health Care as a National Standard.
Objectives: This project aimed to conduct an audit of in-hospital falls prevention practices, to implement evidence-based best practice recommendations and to increase staff compliance with falls prevention best-practice within an acute neurosurgical and an aged care unit in a large tertiary hospital.
Methods: The project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting change in healthcare practice. A baseline audit was conducted measuring eight best practice recommendations, followed by the implementation of targeted strategies and follow up audits.
Results: The baseline audit revealed large gaps between current practice and best practice and overall performance was poor in both sample groups. Barriers for implementation of best practice falls prevention strategies were identified by the project team and numerous strategies, including an education package and falls risk assessment and management plan, were implemented. There were improved outcomes across both sample groups in the follow up audits.
Conclusions: The findings showed how audit may be used to promote best practice in healthcare and that focused education and provision of relevant resources can have an immediate impact on clinical practice. Some of the measured criteria did not improve to a great degree, leaving plenty of room for improvement, however by the end of the project, attitudes to falls prevention on the two wards had been 'transformed' from passive acceptance of falls to active engagement in falls prevention. Future audits are planned to ensure sustainability.