140 Introduction of a post fall medical review pro forma for hospital inpatients

Abstract

Abstract Background Falls are the most common adverse incident in Irish hospital inpatients. 30–50% of inpatient falls result in injury. Older people are more likely to fall and are more likely to sustain an injury. The post fall medical review is critical to assess why a patient fell and if they sustained any injuries. We aimed to audit the quality of the post fall medical review compared to the ‘HSE Service User Falls’ guideline in a university hospital and if the introduction of a post fall pro forma improved the quality of this review. Methods We retrospectively audited the post fall medical review entries of 20 charts of patients who had fallen in hospital. We assessed details such as patient/doctor identifiers, history, examination, management and falls prevention. We introduced a post fall medical review pro forma on two wards in the hospital to aid doctors in their medical review. We then re-audited the quality of the medical review of 9 patients who fell over a two months period and were reviewed using the pro forma. We compared these results to our first audit. Results The post fall medical review pro forma improved the quality of the medical review in multiple domains. 30% of doctors asked if there had been a head strike pre pro forma versus 100% who asked with the pro forma. Joint examination improved from 45% pre to 100% post pro forma. Hip strike history taking improved from 15% to 89%. 70% of doctors recorded the date and 15% recorded the time of assessment pre pro forma. 100% recorded both with the pro forma. Conclusion The post fall pro forma resulted in quality improvement of the post fall medical review. It is a memory aid and also encourages accurate documentation. This pro forma will be introduced hospital wide to improve patient care.