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Content ArticleThe National Audit of Inpatient Falls (NAIF) has published its latest report into the care given to patients who fell while they were in hospital and sustained a hip fracture. Based on data from 1,394 patients in 2021, the report presents information on post-fall management and tracks performance against National Institute for Health and Care Excellence (NICE) Quality Standard 86, which includes checking the patient for injury before moving, using safe lifting equipment and prompt medical assessment after the fall.
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News Article
Rise in hospital falls and bed sores in Scotland since pandemic
Patient Safety Learning posted a news article in News
The number of falls and bed sores recorded in Scotland's hospitals has increased since the Covid pandemic, new data shows. NHS staffing pressures and the deconditioning effect of the Covid lockdown creating more frail patients are being blamed for the rise. The Scottish government paused work on a national prevention strategy for falls when the pandemic started. The strategy has now been shelved and experts argue this is a mistake. Figures released by NHS Healthcare Improvement Scotland (HIS) show that in 2018-19 - the last full year before the Covid pandemic - a total of 26,489 falls were recorded in hospitals. Dawn Skelton, a professor in ageing and health at Glasgow Caledonian University, said there was a "maelstrom" of problems fuelling the increase in hospital falls. She said: "You've got staffing issues definitely but you've also got people who are going in to hospital a step change frailer than they were pre-Covid because of what has happened with all the restrictions. "The people in these falls figures have got no reserves, blow on them and they will fall over, so they are at more risk when they go in." IProf Skelton said it was time to resurrect the Scottish government's falls and fracture prevention strategy as its "value now cannot be underestimated". She added: "Falls and frailty are one of the main causes of long hospital stays and demands on social care and without a spotlight on both the management, but also prevention, the financial and staffing demands on NHS and social care will only rise." Read full story Source: BBC News, 10 November 2022 -
News Article
NHS boss Amanda Pritchard vows that victims of falls won’t wait hours in agony
Patient Safety Learning posted a news article in News
Elderly people who call for help after a fall at home will no longer be left waiting for hours on the floor, the head of the NHS has said, as she bids to keep patients out of hospital and stop the service being overwhelmed this winter. Amanda Pritchard said she would start a new national service within weeks under which community teams would offer immediate help to people who had had an accident but had avoided serious injury. Pritchard, who took over as chief executive of NHS England last year, said a quarter of less severe 999 calls in January involved falls. The new teams could stop 55,000 elderly people a year being taken to hospital, she said. All NHS areas will be told this week to establish the service before a “very, very, very challenging winter” for the health service. Read full story (paywalled) Source: The Times, 16 October 2022 -
Content ArticleA broken hip or ‘hip fracture’ is a serious injury, which each year in the UK leads to around 75,000 people needing hospital admission, surgery and anaesthesia, followed by weeks of rehabilitation in hospital and the community. The National Hip Fracture Database (NHFD) is an online platform that uses real-time data to drive Quality Improvement (QI) across all 163 hospitals that look after patients with hip fractures in England and Wales. This report highlights key research carried out using data from the NHFD in 2021, and makes a number of recommendations to improve treatment and outcomes for patients with hip fractures.
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Content ArticleThe National Institute for Health and Care Excellence (NICE) is developing an update to the guideline on assessment and prevention of falls in older people and people 50 and over at higher risk. It has published the final scope for the update alongside consultation comments and responses, an equality impact assessment and the stakeholder list. The final guidance is expected to be published on 13 June 2024.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Tony talks to us about making patient safety everyone’s responsibility, the importance of open communication and how his understanding of different global health systems has broadened his perspective on what matters in patient care. -
News Article
We need to find alternatives to 999 for care homes and falls
Patient Safety Learning posted a news article in News
The NHS needs to do more to support care homes and people who have fallen with alternatives to ambulance calls and hospital admissions, the NHS England chief executive has said. Speaking at the Ambulance Leadership Forum, Amanda Pritchard acknowledged this winter would be a difficult one for the health service, saying: “The scale of the current and potential challenge mean that we do need to continue to look further for what else we can do… We need to pull out all the stops to make sure that they [patients] get that treatment as safely as possible and as quickly as possible.” She added one area of focus should be making sure certain patient groups can access other – more appropriate – forms of care, rather than calling an ambulance by default and often resulting in hospital admission. On care homes, she said: “Can we wrap around even more care for these care homes so they get to the point where they don’t need to call for help at all or, if they do, there are alternatives pathways [to the emergency department]?” She suggested another area where responses could be made more consistent was for patients who had fallen but without serious injuries, which she said made up a “really significant part of activity”. These patients took a long time to reach and, if admitted to hospital, risked long admissions, she said. Some areas were working to find other ways of responding to non-injury falls patients and trying to keep them away from hospital, she said. Read full story (paywalled) Source: HSJ, 6 September 2022 -
Content ArticleThis guide by the Royal College of Physicians explains what a hip fracture is and answers questions about how patients will be cared for before and after a hip operation. It is written for patients and their families and carers. The guide covers aspects of hip fracture care such as: pain relief memory problems who should be involved in your care how soon an operation should take place eating and drinking bladder problems rehabilitation and physiotherapy following surgery when you will be able to go home future falls prevention bone strengthening medication
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Content ArticleFracture liaison services (FLSs) check if people who have recently broken a bone after falling from a standing height or less (a fragility fracture) might also have osteoporosis – a disease that weakens bones. They then advise on treatments to reduce the risk of another fracture, helping to improve patient outcomes. The Royal College of Physicians (RCP) estimates that at least 90,000 patients in England and Wales who should have anti-osteoporosis therapy are not receiving it. This guide by the RCP's Fracture Liaison Service Database (FLS-DB) aims to help patients and their families and carers understand what to expect following a fragility fracture. It outlines three key findings and the actions that individuals can take to ensure they receive the care and treatment they need from health services.
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Content ArticleThis study in BMC Health Services Research aimed to evaluate the impact of an Internet of Things intervention in a hospital unit. The Internet of Things refers to a network of physical objects that are connected by sensors, software and other technologies in order to transfer data and interact with one another. This study demonstrates the effects of smart technologies on patient falls, hand hygiene compliance rate and staff experiences. The authors reported some positive changes that were also reflected in interviews with staff. They identified behavioural and environmental issues as being particularly important to ensure the success of Internet of Things innovations in a hospital setting.
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Content ArticleWhen something goes wrong in health and social care, the people affected and staff often say, "I don’t want this to happen to anyone else." These 'Learning from safety incidents' resources are designed to do just that. Each one briefly describes a critical issue - what happened, what the Care Quality Commission (CQC) and the provider have done about it, and the steps you can take to avoid it happening in your service.
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Content ArticleNever Events are serious, largely preventable patient safety incidents that should not occur if healthcare providers have implemented existing national guidance or safety recommendations. This document details Never Events that were reported by NHS trusts in England between 1 April 2021 and 31 March 2022. Never Events are categorised by type of incident and by trust.
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Content ArticleIn 2020, over 2,000 people over the age of 60 fell and fractured their hip while staying in hospital in England and Wales. This graphic has been produced by the National Audit of Inpatient Falls (NAIF), which audits the delivery and quality of care for patients over 60 who fall and fracture their hip or thigh bone across England and Wales. It features the three most important findings of the 2021 NAIF Report, chosen by the patient and carer panel. The infographic covers the following questions: How can falls be prevented? What should happen after a fall? How can I help to improve care in hospital?
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News Article
Woman waits six hours for ambulance after fall on her 100th birthday
Patient Safety Learning posted a news article in News
A woman has described how she spent more than six hours of her 100th birthday waiting in agony for an ambulance after slipping and fracturing her pelvis while getting ready for a family lunch. Irene Silsby was due to be picked up by her niece, Lynne Taylor, for a celebration to mark her centenary on 9 April. But she fell in the windowless bathroom of her care home in Greetham, Rutland, and staff called an ambulance at 9am after she managed to summon help. “All I remember is I was in terrible pain,” said Silsby from her hospital bed on Saturday. When asked of the ambulance delay, she said: “It’s disgusting. I don’t know how I stood it so long, the pain was so severe.” Taylor expected to meet the ambulance as she arrived 45 minutes later. But when she reached the care home, the manager said it would be a 10-hour wait, she said. What was to be her aunt’s first trip outside the care home in more than five months turned into her lying on a cold floor surrounded by pillows and blankets to keep her warm and quell some of the discomfort. Taylor, 60, recalled her aunt saying: “They’re not coming to me because they know I’m 100 and I’m not really worth it any more.” Taylor said she had never felt so scared, frustrated and worried. After calling 999 and expressing her outrage, she was told that life-threatening conditions were being prioritised. “I thought she was going to die,” she said. “I didn’t think that any frail, tiny, 100-year-old body could put up with that level of pain on the floor.” Read full story Source: The Guardian, 20 April 2022 -
Content ArticleFalls are the most commonly reported patient safety incident in healthcare, with nearly 250,000 reported from hospitals in England and Wales each year. As well as causing injury to patients, the cost of treating falls is estimated to be around £630 million each year in England. This eLearning course is designed to help healthcare workers prevent patient falls in hospital. There are two modules available: Module 1 is aimed at hospital-based nurses. Module 2 is aimed at foundation level doctors and includes interactive information about patient and environmental falls risk factors, the patient assessment and post fall management. Both modules have been designed to complement, not replace, local falls prevention policies and processes.
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News Article
Lincolnshire Trust fined after patient suffered serious avoidable harm
Patient Safety Learning posted a news article in News
United Lincolnshire Hospitals NHS Trust has been ordered to pay a total of £111,204 in fines and legal costs after pleading guilty to failing to provide safe care and treatment to an elderly patient, causing them avoidable harm, following a sentencing hearing on Friday, 25 March at Boston Magistrates’ Court. The case was taken by the Care Quality Commission (CQC) under regulations 12 and 22 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The case against United Lincolnshire Hospitals NHS Trust involved the care of an elderly patient, Iris Longmate, who was admitted to the Greetwell Ward at Lincoln County Hospital on 20 February 2019. On March 3, 2019 Iris fainted and fell unsupervised from a commode, and was found face down on the floor in her room. Iris sustained spinal injuries and a cut to the head as a result of the fall, but then also suffered significant burns to her thigh and left arm as a result of being pressed against a radiator whilst being assessed by staff following the fall. Iris was subsequently transferred to Queens Medical Centre for assessment and treatment. She sadly contracted pneumonia in hospital and died on March 14, 2019. United Lincolnshire Hospitals NHS Trust pleaded guilty to a single offence of failure to provide safe care and treatment causing avoidable harm to Iris, for which the trust was fined £100,000. The court also ordered the trust to pay £170 victim surcharge and £11,034 costs to the CQC. The trust was found to not have taken all reasonable steps to ensure that safe care and treatment was provided, resulting in avoidable harm to Iris. In pleading guilty to the offence of causing avoidable harm to Iris, the trust also acknowledged that other patients on the Greetwell Ward had also been exposed to a significant risk of avoidable harm. Fiona Allinson, CQC’s deputy chief inspector of hospitals, said: "This death is a tragedy. My thoughts are with the family and others grieving for their loss." "People have the right to safe care and treatment, so it’s unacceptable that patient safety was not well managed by United Lincolnshire Hospitals NHS Trust," she said. "Had the trust addressed the issues with the exposed heating pipes before Iris fell, she wouldn’t have suffered such awful burns injuries." Read full story Source: Medscape, 2 April 2022 -
Content ArticleAs well as having a significant negative impact on the health and wellbeing of people with dementia, falls increase service costs related to staff time, paramedic visits, and A&E admissions. This study in the Journal of Patient Safety examined whether a remote digital vision-based monitoring and management system had an impact on the prevention of falls. The authors concluded that a contact-free, remote digital vision-based monitoring and management system reduced falls, fall-related injuries, emergency services time, clinician time, and disruptive night time observations. This benefits clinicians by allowing them to undertake other clinical duties and promotes the health and safety of patients who might normally experience injury-related stress and disruption to sleep.
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Content Article
In this blog, Jayne Flood, Falls Prevention Practitioner at East Kent Hospitals NHS Foundation Trust, describes how her team introduced ‘yellow kits’* to assist patients at high risk of falls in A&E, and evaluated their impact. *Developed in partnership with Medline Industries Ltd.- Posted
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Content ArticleBarbara Young fell downstairs at her home at 11.30am on 15 July 2021, sustaining multiple injuries including fractures of her ribs, spine and skull. Her family immediately called the emergency services and informed the ambulance call handlers that she had fallen downstairs, was not fully conscious and had sustained an apparently severe head injury. An ambulance subsequently arrived at 2.26pm and she was taken to hospital where, due to her reduced mobility, she developed pneumonia. Mrs Young’s conditioned worsened over the coming days and she died on 24 July 2021. In her report, the Coroner raises concerns about the ambulance waiting time in this case, and more generally about ambulance response times in cases where elderly patients experience falls.
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Content ArticleBarrie Housby had a medical history that included frailty, Parkinson’s disease and macular degeneration. During a stay at Clifton Hospital he was known to be at high risk of falls and at the beginning of the nightshift on 12 July 2021, it was advised that he should be cared for on a one to one basis and not left unattended. During the shift, a member of staff allocated to monitor him left the bay to attend to other duties, and in this time Mr Housby left his bed and fell. He was transferred to a hospital emergency department but subsequently died on 13 July 2021 as a result of a traumatic subdural haemorrhage following a fall. In his report, the Coroner Alan Wilson highlights the impact of staffing shortages at the Trust and their contribution to Mr Housby’s death, stating that this poses an ongoing risk to patient safety.
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EventThis Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night, and moving forward during and beyond the Covid-19 pandemic. The conference will also focus on improving staff well-being at night and reducing fatigue. Attending this conference will enable you to: Network with colleagues who are working to improve Hospital at Night Practice Learn from developments as a results of Covid-19 Improve your skills in the recognition management and escalation of deteriorating patients at night Understand and evaluate different models for Hospital at Night Examine the role of task management solutions for Hospital at Night, including handover and eObservations Ensuring effective and safe staffing at night, including adequate breaks Examine Hospital at Night team roles, competence and improve team working Improving safety through the reduction of falls at night Supporting staff and reducing fatigue at night Develop the role of Clinical Practitioner and Advanced Nursing Practice at night Identify key strategies to change practice and ways of working in Hospital at Night Understand how hospitals can improve conditions for night workers and support Junior Doctors Improve the management of pain at night Work across whole systems to improve support for patients out of hours Self assess and reflect on your own practice Gain CPD accreditation points contributing to professional development and revalidation Evidence Register There are a limited number of free places for hub members. Email: info@pslhuborg if interested. Follow on Twitter @HCUK_Clare #hospitalatnight
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Content ArticleThe National Audit of Inpatient Falls (NAIF) has published their latest report into the care given to patients who fell while they were in hospital and sustained a hip fracture. Based on data from 1,357 patients in 2020, the report presents information on post-fall management and tracks performance against NICE Quality Standard 86, which includes checking the patient for injury before moving, using safe lifting equipment and prompt medical assessment after the fall.
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News Article
Resident died after treatment at failing care home
Patient Safety Learning posted a news article in News
A resident at an inadequate care home died after their blood glucose increased to high levels and staff acted too slowly, a report found. Inspectors said The Berkshire Care Home in Wokingham breached guidelines in nine areas and must improve. They found residents were put at risk after medicines were not used properly and that records were not up to date. The Care Quality Commission (CQC) said an ambulance was only called for the person who died when they were found to be unresponsive. They later died in hospital. Its report said staff were "not sufficiently skilled" to safely care for people with diabetes. A resident was given paracetamol and co-dydramol eight times over three days, when they should not be used together because they both contain paracetamol, the report said. Another person was burned by a cup of tea and staff did not treat the injury properly, leading to the person developing an infection and later being admitted to hospital. Staff sometimes felt "rushed and under pressure", the report found. Read full story Source: BBC News, 18 December 2021 -
Content ArticleDespite decades of research into patient falls, there is a dearth of evidence about how the design of patient rooms influences falls. This multi-year study aims to better understand how patient room design can increase stability during ambulation, serving as a fall protection strategy for frail and/or elderly patients.
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Content ArticleThis manifesto was created by the Community Rehabilitation Alliance, a collective of 50 charities, trade unions and professional bodies coming together to call on all political parties to ensure there is equal access to high quality community rehabilitation services for all patients.
