In-Patients Falls Audit- A Quality Improvement Project

Introduction:

Falls in older adults are a common presentation to A&E. As per a report, over 1300 people experienced femoral fracture following a fall in 2021.  Falls can be multifactorial, and evaluating this is important.

A patient with a new inpatient fall can develop complications like fractures and prolonged hospital stay, leading to higher morbidity and mortality. We noticed that patients admitted with different illnesses develop new inpatient falls in the wards. Hence, we decided to conduct a QI project to review the condition and the circumstances surrounding the falls as an inpatient.

Methodology

The data was collected from the patients admitted under the Medicine for Older People Department. The source was from the incident reports filed under the Quality and Safety Patient. 1st Cycle: August – October 2023, and collected 38 patient details and 2nd Cycle Sample period- May to July 2024, collected 31 patients.

Results

The average age of older persons with inpatient falls was octogenarians, with overall Prevalence of MCI/ dementia (23%) and delirium (48%), as compared to 47% and 58 % in the previous audit. 1:1 care was needed in 26 %, and almost 50% had delirium. Most falls occur in the afternoon and evening/ night. Morbidity, injury with harm ( 32 vs 34% previous audit) and mortality ( 29% vs 21% previous audit). 23% of fall patients had head injury and 0% had femur fracture as compated to 16% and 8% previous audit. Compliance with Multifactorial Falls Risk Assessment (MFRA) was noted. Hospital stays increased among the patients with New inpatient falls. Recommendations were given to the Hospital Falls Strategy group.

Conclusion

New inpatient falls are a serious concern, leading to an increase in morbidity and mortality among the elderly population. Falls prevention and the use of MFRA are valuable tools for early identification and prevention.