Title: Improving the Assessment and Prevention of Falls and Fractures on a Rehabilitation Ward
Presentation Type: Virtual Presentation
Chimezie Alexandra Nzeji, Tallaght University Hospital, Ireland
Fayaz Rahaman, Tallaght University Hospital, Ireland
Ruha Makhura, Tallaght University Hospital, Ireland
Aoife Fallon, Tallaght University Hospital, Ireland
Anna McDonough, Tallaght University Hospital, Ireland
Background: The National Steering Group and NICE provide guidelines on medical assessment and prevention of falls and fractures (1)(2). This audit assesses and compares quality of practice on an Age-Related rehabilitation ward against these guidelines.
Methods: A retrospective audit, including all patients(n=31) on an off-site, Age-Related rehabilitation ward was completed. Data on falls and fractures at emergency department presentation and during admission was obtained through chart review. Following education and implementation of a falls pro-forma, a re-audit was completed at four months including all patients(n=40).
Results : In cycle 1, mean age of patients was 80 years (range 56-94), 39%(n=12) were admitted with a fall of whom 66.7%(n=8) had a resulting fracture. In cycle 2, mean age was 82years(range 63–95), 48%(n=19) were admitted due to a fall, of whom 53%(n=10) had a fracture.
A falls assessment and bone health review was completed in 39%(n=12) of all patients in cycle 1, and in 37%(n=3) admitted with a fall. This increased to 83%(n=33) of all patients in cycle 2 and 100%(n=40) of those admitted with a fall. Pre-intervention, 23%(n=7) had an inpatient fall compared to 18%(n=7) post-intervention; of these, 43%(n=3) and 14%(n=1) resulted in fractures respectively.
Conclusion: Compliance with national guidelines for prevention of falls and fractures improved with education and implementation of a falls pro-forma. This resulted in a reduction in falls, particularly injurious falls, on a rehabilitation ward. In future, this pro-forma may be implemented in other hospital wards.
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