Falls prevention in hospital

The aim of this page is to advise you how we will help reduce the risk of you falling whilst you are in hospital.

Reducing falls is important for maintaining everyone’s health, wellbeing, and independence. Older people often have more falls and are more at risk of injury. Falls can become recurrent and cause injuries including hip fractures and head injuries. Falls can be life changing through the injuries they cause and the fear of falling that they create.

A fall happens when someone accidentally ends up on the ground or a lower surface. It’s not caused by a major health issue like a stroke or a dangerous situation. Falls can happen to anyone and can be just a natural part of how our bodies work.

Falls often happen because of multiple risk factors. These include:

Muscle weakness.
Poor balance.
Visual impairment.
The use of certain medications or a combination of several medications.
Environmental hazards such as steps, trailing cables, or wet floors.
Some specific medical conditions might make people more likely to fall, such as dementia, stroke, or Parkinson’s disease

Each month North Bristol NHS Trust supports around 29,400 admitted patients. Around 180 falls are recorded for these patients each month (2023 data).

Can we prevent falls?

Like in normal life, it is not possible to prevent all falls in hospital. However, we can work together to reduce the chances of this happening.

Research has shown that the best chance of reducing falls is when staff such as doctors, nurses, and therapists work together. You and your family can also help by being aware of the risks and the actions you can take, as well as talking to the people looking after you about falls prevention.

North Bristol NHS Trust sees preventing falls as a priority and aims to reduce the risk of falls during your hospital admission by:

Assessing all patients when admitted for the risk of falls and delivering individual care to manage this.
Regularly reassessing patients if their condition changes.
Responding quickly to hazards.
Patients with higher risk of falls will be identified and provided with the appropriate level of care. This can include additional checks, supervision or moving to more visible area on the ward.
Patients will be assessed individually for equipment, bed rails, and aids.
Making the hospital environment as safe as possible. Training staff with regular updates.
Encouraging staff, patients, and visitors to report any falls. This allows us to learn from previous falls

What can we do together?

This list can be used by patients, their carers, and families.

Hospital staff will ask you as part of your assessment. Tell the staff if you have

Fallen in the past year.
Are worried about falls.
Have a history of falls.

Talk to staff if you feel confused or disorientated

This could be a sign on delirium, and staff can give support for this.
If you are a visitor and notice your friend or relative is not acting themselves, please alert the staff.

Use your call bell

Use your call bell if you need help to move.
Especially if you need help going to the toilet.
When ward staff or visitors leave, make sure they leave your call bell where you can reach it.

Use your glasses

Make sure your glasses are clean and used as prescribed.
Ask for help if you are having trouble seeing.
Use a night light to make sure you can see in dim light.

Use your walking aid

Keep your usual walking aid close by.
Check for wear and tear, particularly on the rubber feet.
Never lean on hospital furniture as it often has wheels.
Ward staff can provide walking aids to use while you’re in hospital.

Footwear

Make sure your shoes and slippers fit well, grip well, and don’t fall off.
Ask relatives to bring in well fitting shoes or ask the ward staff for socks with grips.

Do simple exercises before getting out of bed

Point your toes and release them a few times.
Tighten the muscles in your calves and then release them.
Move your legs up and down if you can.
This will get the circulation going.

Getting out of bed

Sit up straight for a few moments on the edge of your bed before standing.
Get up slowly.
Make sure you feel steady before walking.
Ward staff may check your blood pressure while sitting and standing as part of the falls assessment.

Eating and drinking

Drink and eat regularly.
Staff will provide jugs of water and can give you light snacks.

Going to the bathroom and toilet

Take care when using the bathroom and toilet.
Ask for help if you need assistance.

Keep active during your stay

Complete exercises in the chair.
Take opportunities for supported walks with visitors or staff. This helps you maintain your strength.
Be aware of your environment and ask for clutter to be moved if your path isn’t clear.
If you feel dizzy: stop, sit down, let the ward staff know.

If you fall whilst in hospital

Despite our best efforts some patients will fall whilst in hospital. If you do fall, the nurses and doctors will check for signs of injury and provide treatment if needed. We will record the fall in your medical notes as well as on our incident reporting system. With your consent we will inform your chosen representative (usually a friend or family member).

What you can at home

STEP is an exercise programme you can do sitting in a chair. If you feel well enough, you can start them in hospital and carry on when you return home. The exercises aim to increase your strength and balance and they are designed for people who find it difficult to get out and about.

To find out more about STEP go to: Start Today Exercise Programme (STEP) - Sirona care & health