Created for clinicians, Supporting best and safe practice in post-fall management in inpatient settings clarifies what constitutes a post-fall check for injury. By providing guidance on how to implement best practice in post-fall management processes, training and competencies.
Post-fall management is audited against National Institute of Clinical Excellence (NICE) quality standard 86, statements 4, 5 and 6.
Quality statement 4: Checks for injury after an inpatient fall
Quality statement 5: Safe manual handling after an inpatient fall
Quality statement 6: Medical examination after an inpatient fall.
While there have been small increases in performance against these standards from 2018 to 2021, there is plenty of room for improvement. In 2021, 71% of inpatients who sustained a femoral fracture were checked for an injury before moving. However, injury was suspected in only 47% of those checked (NAIF report 2021).
If a femoral fracture is suspected, this will impact on subsequent decision making, such as choosing to safely move the patient from the floor using flat lifting equipment and facilitating prompt medical assessment. Not recognising the possibility of a serious injury could at best increase the pain and distress associated with the fall and at worst delay management, leading to poorer outcomes.
People who sustain a femoral fracture as an inpatient are twice as likely to die within 30 days than those who fracture in a non-inpatient setting (NAIF 2021 interim report), highlighting the vulnerability of inpatients who sustain serious fall-related injuries, and the importance of high-quality and safe post-fall management. However, there are no simple or easy solutions to achieve this.
This document is the result of a multidisciplinary collaboration bringing valuable contributions and expertise from colleagues with paramedic, specialist trauma, orthogeriatric, acute, community and mental health nursing and allied health backgrounds. This resource begins by attempting to answer the question ‘What is a post-fall check?’ and aims to:
- minimise harm to patients from incorrect management after injurious falls
- ensure prompt access/referral to ongoing treatment when injury has occurred
- reduce variation(s) in post-fall management within inpatient settings.
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