Don’t stop moving: Optimising safety while staying active in hospital. The 2024 National Audit of Inpatient Falls (NAIF) report on 2023 clinical data (10 October 2024)

Summary

The National Audit of Inpatient Falls (NAIF) is a continuous audit of all inpatients who have a fall that results in a femoral fracture. This report looks at clinical data on falls collected in 2023. Based on 1,609 cases, it states that falls prevention activity should not focus solely on older people’s wards, finding that nearly half of all inpatient femoral fractures (IFFs) occur on general medical wards.

To address the potential for harm caused by hospital-acquired deconditioning, this report presents a new approach to risk factor assessment that focuses on promoting activity to ensure each patient is fit to move as safely as possible. This covers factors such as vision, medication review, delirium, mobility and continence, and provides information on the proportion of patients affected by each in 2023, compared to 2022 and 2021.

It contains five key recommendations, four of which state that Trusts and health boards should:

• Review their policies and practice to ensure that older hospital inpatients are enabled to be as active as possible
• Ensure that there are robust governance processes in place to understand when post-fall checks fail to correctly identify a fall related injury’
• Have processes in place to hasten time to administration of analgesia after an injurious fall
• Prepare for the audit expansion in January 2025.

The fifth recommendation states that NHS England and the Welsh Government should implement national drivers to ensure that all older people are screened for delirium upon hospital admission and reviewed for changes suggestive of a new onset of delirium for the duration of their admission.