Compliance With Multifactorial Falls Risk Assessment And Post-Fall Management In Older Inpatients: A UK Clinical Audit

Introduction
Falls in hospitalised older adults are a major cause of morbidity, prolonged hospital stay and increased healthcare costs. NICE guidelines recommend multifactorial falls risk assessment (MFRA) and structured post-fall management to reduce fall-related harm. This audit evaluated compliance with MFRA and post-fall management following inpatient falls in a UK district general hospital.

Method
A retrospective clinical audit was conducted at Luton and Dunstable University Hospital. All inpatient falls resulting in harm during 2025 were included. Data were collected from electronic medical records, nursing assessments and discharge documentation. Compliance with MFRA components (mobility, medication review, continence assessment, lying/standing blood pressure, vision assessment and delirium screening) and post-fall management measures (doctor review, injury assessment, safe transfer and analgesia prescription) was evaluated.

Results
A total of 130 inpatient falls with harm were analysed. Overall MFRA completion was 75%. Compliance varied across domains: mobility assessment 80%, medication review 69%, continence assessment 67%, lying/standing blood pressure 67% and vision assessment 57%. Delirium assessment showed the lowest completion rate at 25%. Post-fall management demonstrated higher compliance, with doctor review and analgesia documented in 80% of cases, injury assessment in 70% and safe transfer in 58%.

Conclusions
While most patients received appropriate medical review following a fall, gaps remain in delirium screening and documentation of falls-related assessments. Targeted staff education and improved electronic documentation systems may enhance compliance with guideline-recommended falls prevention practices.