Abstract
Background: Around one in three adults aged 65 years and over will have a fall at home within a one-year period. Falls are estimated to cost the NHS more than £2.3 billion per year. The National Institute for Health & Care Excellence (NICE) guidelines recommend older people who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment which includes a cardiovascular examination and review of medications. Orthostatic hypotension (OH) is a common cardiovascular disorder, independently associated with an increased risk of falls in the elderly.Aims & Objectives: This study was carried out to assess improvement in lying and standing blood pressure (LSBP) measurement using clinical audit and staff education.Method: An initial audit of patients over the age of 60, admitted with a hip fracture between the 14th of April and the 25th of May 2020 to assess measurement and accurate recording of LSBP. This cycle was followed by brainstorming, root cause analysis, teaching sessions for staff, and use of aide-memoires. A second audit cycle of patients was admitted with a hip fracture secondary to a fall between the 10th of August and the 21st of September 2020.Result: Our initial audit results showed 68% of patients who met the criteria in the NICE guidelines on measurement of LSBP were not being assessed for OH. Following interventions, the second audit cycle showed significant improvement in compliance, confirming audits to be a powerful tool in quality improvement programs.
Highlights
A fall is defined as an event that results in a person coming to rest inadvertently on the ground or other lower level [1]
The National Institute for Health & Care Excellence (NICE) guidelines recommend older people who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and balance be offered a multifactorial falls risk assessment which includes a cardiovascular examination and a review of their current medications by managing clinicians [7]
Following a root cause analysis, it was discovered that there was a lack of sufficient training amongst ward staff on the standard procedure for the accurate measurement and documentation of lying and standing blood pressure (LSBP) which led to poor compliance with set standards over time
Summary
A fall is defined as an event that results in a person coming to rest inadvertently on the ground or other lower level [1]. Around one in three adults aged 65 and over will have a fall at home within one year. The human cost of falling is unquantifiable and includes physical distress, pain, injury, loss of confidence, loss of independence and mortality. Falls are a public health concern estimated to cost the NHS more than £2.3 billion per year and have a negative impact on patients' quality of life [4]. Falls are estimated to cost the NHS more than £2.3 billion per year. The National Institute for Health & Care Excellence (NICE) guidelines recommend older people who present for medical attention because of a fall, report recurrent falls in the past year, or demonstrate abnormalities of gait and/or balance should be offered a multifactorial falls risk assessment which includes a cardiovascular examination and review of medications. Orthostatic hypotension (OH) is a common cardiovascular disorder, independently associated with an increased risk of falls in the elderly
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