Abstract

Patient safety is a key domain of quality care within the hospice setting. It is important to ensure clinical excellence and promoting safety through standards of practice. It is widely acknowledged and accepted within the palliative care setting that the progressive deterioration of both cognitive and physical/motor skills with disease process, treatment effects, and aging means falls are increasingly common. In addition patient autonomy becomes more important as they seek independence and quality of life as they deteriorate and death nears. Standards Countess Mountbatten House is a 27-bedded in-patient unit. All patients on admission are assessed using a Falls Risk Assessment Tool due to their clinical condition and treatments all patients are highlighted as a high risk of falling and this is reflected in the recent data. Data May 2017- April 2018 Countess Mountbatten House inpatient unit had 539 admissions with total of 86 patient falls, 59 of which were unwitnessed, 11 from patients walking/standing and 10 from falling from bed to floor (majority onto falls mats as part of the falls prevention plan of care). This a 25% reduction in patients falls compared to May 2016 – April 2017 when 503 patients were admitted with a total of 115 patient falls recorded, 74 of which were unwitnessed, 18 from patients walking/standing and 12 falling from a bed to floor. This demonstrates evidence best practice, prevention and management. Falls management How have we achieved this improvement in our patient care? Observation bay created introducing bay watch, increased training and education, empowering staff at all levels to recognise high falls risks, act upon changes in patient condition promptly, improved collaborative working with families, low threshold for additional staff to provide 1:1 care, improved communication and initiatives with multi- professional team. Use of sensor and motion mats and turnaround project.

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