Date Published: 26 February 2007
NPSA launches most comprehensive report yet on patient falls in hospital
Patient falls can have a significant impact on patients, their relatives and hospital staff. In a report launched today, the National Patient Safety Agency (NPSA) uses learning from the NHS to reveal the most comprehensive national picture yet of when, where and why patients fall.
The human cost of falls can include distress, pain, injury, loss of confidence and loss of independence, while the overall direct healthcare cost to the NHS is estimated at Â£15 million every year. In an average 800-bed acute hospital trust there will be around 24 falls every week (over 1,260 falls every year). Associated healthcare costs are estimated at a minimum of Â£92,000 per year for an average acute trust.
This report aims to improve NHS organisations' understanding of the scale and consequences of patient falls in hospitals, identify areas where efforts to reduce falls and injury are needed most and direct NHS staff to some of the evidence-based resources for preventing falls.
Slips, trips and falls in hospital will be launched today at York Hospital, in recognition of the work York Hospitals NHS Trust has done to achieve a significant reduction in the number of patient falls.
Launching the report, Professor Richard Thomson, the NPSA's Director of Epidemiology and Research, said:
“ Patient falls account for almost two-fifths of the patient safety incidents reported to the NPSA. Data from our National Reporting and Learning System ( NRLS) shows that most falls are related to the effects of illness and the aging process, with very few due to environmental hazards such as wet floors or steps. Poor mobility and confusion are often contributing factors, with older patients - particularly those over 80 - most vulnerable.
_ Preventing patients from falling is a particular challenge in hospital settings because a patient's safety has to be balanced against their right to make decisions and retain dignity and privacy, and there will always be a risk of falls given the nature of the patients that are admitted to hospital. However, this piece of work aims to support the NHS in reducing these risks.”
Patient falls, including slips and trips, are the most common patient safety incident reported to the NPSA via its NRLS. The majority of falls (96%) result in low or no harm, but a very small minority result in significant injury or death. Of over 200,000 falls reported to the NPSA, 26 resulted in the patients' death, with further deaths likely to have occurred following hip fractures.
The NPSA is recommending ways of identifying and acting on reversible risk factors, which research evidence has indicated could result in a possible reduction in falls by up to 18%. As well as recommendations that can improve the care of patients vulnerable to falling, the report includes a synopsis of research evidence on preventing falls, with examples of practical ways of implementing effective interventions that can reduce risk. These include reviewing medication associated with falls, detecting and treating eyesight problems, physiotherapy, access to walking aids and providing safer footwear.
Professor Ian Philp, National Director for Older People, said:
“ The cost of falls to the NHS, both in financial and human terms, is enormous; I welcome the work that the NPSA is doing to improve understanding of the problem and to encourage the implementation of practical solutions.
_ The findings outlined here complement my own Recipe for Care report which calls for improvement in the provision of care and services for the UK's elderly population and highlighted the importance of early intervention and assessment of falls and fractures.”
The report is supported by new NPSA guidance on the safe and effective use of bedrails. It aims to ensure that NHS staff are better informed about relative risks of falls and injury with and without bedrails, that bedrails are not used inappropriately as restraints, and that they are used for preventing falls when the benefits outweigh the risks.