NAIF Round Two Methodology

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National Audit of Inpatient Falls (NAIF) is a clinically led, web-based audit of inpatient falls prevention care in acute hospitals in England and Wales. NAIF aims to improve inpatient falls prevention through audit and quality improvement.

Audit items for round 2 were primarily drawn from NICE clinical guideline Falls in older people: assessing risk and prevention (CG161). To see how the audit dataset is linked to NICE Guidance please view the mapping document.

Dataset development

The organisational audit had two sections that were completed at hospital trust or LHB level. Section one included policies, protocols and paperwork and section two included leadership and service provision. The clinical audit was a snapshot of the care provided to a sample of up to 30 patients aged over 65, who were in hospital for over 48 hours, after being admitted for a non‐elective reason. The clinical audit consisted of two sections. Section one included evidence of assessment and intervention in case notes and section two included observation at bedside / patient environment.

Data completeness and audit participation

All data were collected and entered locally into a secure web tool. There was a very high participation rate in the organisational audit – of the 142 eligible acute hospital trusts and LHBs in England and Wales, 97% (138) submitted data. The participation rate for the clinical audit was also very high at 95% (n = 187/197). In addition, four hospitals in Northern Ireland and one hospital in Jersey also submitted data. The organisational and clinical audit had high levels of data completeness. In the organisational audit, 9 out of 16 questions had 100% completion, with the remaining 7 questions having over 98.5% data completeness. All the questions in the clinical audit had at least 97.5% data completeness.

Community hospitals

In Round 1 of the audit, we collected data from acute hospitals only. Many patients are transferred to community hospitals for rehabilitation following an acute illness or admitted directly from home when unwell. These patients are often the frailest of inpatients and have similar or higher risks for falls, especially those with dementia and delirium. We, therefore, conducted a pilot audit of those patients in community hospitals to see whether they could be audited in a similar way to those in acute hospitals. As the number of admissions per day is far smaller in community than acute hospitals community hospitals used a different sampling approach.