North Bristol NHS Trust announces safety measures to reduce patient falls

Thursday, 25 September 2014

North Bristol NHS Trust has announced a range of patient safety measures to reduce the number of patient falls.

The Trust is committed to patient safety and was one of the first 12 NHS organisations in England to sign up to the Government-led Sign Up to Safety initiative.

The move into the Brunel building at Southmead Hospital Bristol, which has 75 % single rooms, involved training and development  for all staff in new ways of working to care for patients.

To prevent the risk of falls, the Trust put in place a revised ‘patient falls’ policy. This policy includes an assessment of all new patients to assess their falls risk.

Among the measures the Trust has put in place are:

  • Giving patients at particularly high risk of falls slipper socks with grips on them.
  • Magnets are used on patient boards so that all staff who come on to a ward can see at a glance which patients are at risk of falling.
  • Because there is a link between patients who are prone to falls and dementia, the lead dementia nurse and doctor are ensuring all staff have the support they need to help these patients.
  • When patients are in their own en-suite bathrooms if they are at risk of falling but they want to be in the bathroom alone, a member of staff will wait outside the door.
  • The way nurses care for patients in single rooms means that they can keep an eye on patients – nurses have bases between four rooms, which combined with an open door policy means they can watch out for patients.
  • Patients that are at particularly high risk of falls can receive one-to-one care.
  •  Hourly checks are done on all patients (this is called intentional rounding).

Since the opening of the new Brunel building, in May, the Trust has taken account of the experiences of its patients and has now further improved the falls policy and practice. 

Since May the number of falls in the Trust was 701, 14 of these caused serious harm. The most common harm from a serious fall is a fractured hip, which older patients are at particular risk of.

The rate of falls per 1,000 bed days was just above eight in June and has since dropped to six per 1,000.

Director of Nursing and Quality at North Bristol NHS Trust, Sue Jones, said: “We anticipated that there might be a rise in falls upon the transfer to the new hospital.

"To prepare for this we have been developing our practice in recent years and improving our falls rate. Our rate of falls causing harm in the last 72 hours is recorded monthly for the national ‘safety thermometer’ and is below the national average.

  • When there is an incident we review every case for the root cause and any new learning is immediately put in to practice.
  • There are patients who come into hospital who are at particular risk of falls, such as those with dementia and people who are frail and elderly.  A risk assessment is carried out when patients are admitted to ensure the right level of care is provided to reduce the risk of falling.For high risk patients this includes the use of one-to-one care.
  • All patients are observed and assessed on an hourly basis and nursing staff base themselves in the corridors outside groups of rooms. There is an open door policy so that patients can be seen inside their rooms.

"We take this matter very seriously and are working on further improvements to our practice.”

The reduction of patients’ falls is one of the Trust’s strategic quality and safety priorities. The Trust’s other quality and safety priorities are within the Trust’s Quality Account.