Background: Falls are an ongoing problem within the acute clinical setting and can have a detrimental effect on the patient. Falls are however preventable with appropriate intervention. This falls prevention project focused on this issue; to address the need of preventative interventions. The focus group involved a large acute metropolitan hospital. The wards chosen were two 30 bed wards; a General Medical ward and an Orthopaedic Surgical ward. They were selected by the Director of Nursing due to their relatively high falls rates.
Objectives: The aim of this project was to audit current practice of falls prevention within the acute clinical setting, to improve practice in the prevention of falls in accordance to the best available evidence, to implement interventions according to the findings; to improve compliance, accuracy and sustainability, and to re-audit to identify further change.
Methods: This project consisted of three phases. Phase 1 included forming the project team and conducting the baseline audit, using the Practical Application of Clinical Evidence System; developing the interventions from identified gaps through Getting Research into Practice framework; and the post implementation audit/follow-up audit using the Practical Application of Clinical Evidence System audit criteria. There was also an additional follow-up audit conducted to assess the sustainability of the implementation strategies.
Results: The baseline audit showed a number of gaps, which allowed for a number of interventions to be implemented. The follow-up audit showed improvement in the completion of the Falls Risk Assessment Tool compliance, improved staff education of the Falls Risk Assessment Tool and staff acting on the falls risk result by implementing the appropriate strategies. There was, however, disappointing results where the Falls Risk Assessment Tool was not completed accurately, and that patients and families did not receive education about the patients' falls risk. This continued to be evident in the results of the second follow-up audit, which showed further disappointing results.
Conclusions: The findings showed a generally positive result at the initial follow-up audit phase; staff education levels increased and more appropriate action was taking place within the clinical setting. However, due to barriers out of the control of the falls team, there were less positive results in the second follow-up audit. However, with more support, time, and resources, the compliance of implementation strategies may be sustainable and falls within the acute clinical setting could be prevented and better health outcomes achieved.