Improving the Measurement and Documentation of Low Systolic Blood Pressure (LSBP) in Patients with Falls Risk.

INTRODUCTION
Postural hypotension is a significant modifiable risk factor for inpatient falls in older 
adults. National guidelines recommend lying and standing blood pressure (LSBP) 
measurement for patients at risk of falls. On our geriatric wards, which care for acute, 
long-stay and orthogeriatric patients, we observed inconsistent LSBP documentation 
and delays in identifying postural hypotension. Staff reported difficulty locating LSBP 
records and a perception that fall prevention was being deprioritised in comparison to 
post-fall care. This project aimed to assess current practice and identify opportunities to 
improve recognition and documentation of LSBP in patients with falls risk.

METHOD
We performed a retrospective review of 63 patients identified as being at risk of falls 
between April and June 2025. We recorded whether LSBP was requested, measured, 
and documented, as well as whether this was completed within 24 hours of admission. A 
staff survey (n=20) was used to explore perceived barriers to LSBP measurement and 
documentation.

RESULTS
Of the 63 patients, 34 (54%) had LSBP requested in the notes and 22 (35%) had LSBP 
recorded. Only 18 patients (29%) had both requested and recorded. Survey responses 
identified time constraints, unclear responsibility between doctors and nurses, and lack 
of guidance on follow-up or acting on abnormal findings.

CONCLUSIONS
This initial review identified documentation gaps and system-level barriers to routine 
LSBP monitoring. Planned interventions include teaching sessions, posters, 
interdisciplinary discussion and the introduction of documentation prompts. These aim 
to embed LSBP measurement into routine practice, improve early identification of 
postural hypotension and reduce avoidable inpatient falls