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National Audit of Inpatient Falls Report Autumn 2021

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The third report of the continuous National Audit of Inpatient Falls (NAIF) covers 2021 England and Wales facilities audit data and clinical audit data from 1 January to 31 December 2020. 

Please share your feedback on the Autumn 2021 report with our quick survey here.

Key recommendations

Data quality
1. Clinical leads should assess the extent of the gap between actual and
reported falls in your trust or health board if more than 10% of
inpatient femoral fractures (IFFs) are recorded in NAIF as not
attributable to a fall. Higher proportions of IFFs not attributed to a fall
suggest under-reporting.

Clinical (for clinical teams)
2. Clinical leads should implement quality multi-factorial risk
assessments (MFRAs) in all ward types, as inpatient falls can happen

3. Senior leaders and clinical teams should run at least one quality
improvement (QI) project per year aimed at improving the quality of
MFRA and to ensure care plans are followed.

4. Falls leads and clinical teams should use QI methods to address poor
performance against NICE Quality Standard 86 statements 4, 5 and 6
(NAIF KPIs 2, 3 and 4).
         4: Checks for injury after an inpatient fall
         5: Safe manual handling after an inpatient fall
         6: Medical examination after an inpatient fall
Timely and effective post-fall management improves outcomes for

5. Clinical teams should administer analgesia as soon as a provisional
diagnosis of IFF is made, aiming for within 30 minutes of the fall.

6. Senior leaders should review patients who have experienced delays in
starting femoral fracture management in inpatient settings to identify
where systems and processes can be improved to avoid delays.

7. Falls leads and senior leaders should review NAIF reports and online
real-time data for your trust in quarterly meetings of multidisciplinary
team (MDT) falls working groups, so that these can be drivers for local
QI projects.

8. Senior leaders should include time for participation in NAIF and
related QI activities in job specifications and plans for falls