Falls Awareness Week 2024: The impact of inpatient falls
The National Audit of Inpatient Falls 2023 tells us that falls are the most frequently reported incident affecting hospital inpatients. As of 2022, more than 240,000 falls were reported in acute hospitals and mental health trusts in England and Wales. Unfortunately, falls can have a serious physical and mental implications on the patient. [2]
To raise awareness of inpatient falls and prevention methods this Falls Awareness Week, we explore the facts and figures behind inpatient falls in the UK.
The facts and figures
Inpatient falls can occur for numerous reasons. This may be things such as: limited mobility, certain health conditions, poor vision, delirium, and muscle weakness. Let’s take a look at some of the recent statistics on falls in hospitals.
- 20-30% of falls can be prevented by assessing risks and intervention.
- Inpatient falls are predicted to cost approximately £2600 per patient.
- 30-50% of falls result in some physical injury, and fractures occur in 1-3%.
- Recent audit data shows an average of 6.63 falls per 1000 occupied bed days.
- The cost of treating falls in hospitals in the UK is estimated at £630 million per year.
- 100,000 of 250,00 inpatient falls patients suffered bruises, grazes, lacerations or more serious injuries.
- In England, the % of hip fractures due to an inpatient fall has decreased from 5% in April 2022 to 3% in October 2022.
- Around 2000 hip fractures and 600 other fractures are reported each year. 130 deaths associated with falls in hospitals were also reported.
The physical and mental impact of falls
Falls in general were the ninth highest cause of disability-adjusted life years in England in 2023, and the leading cause of injury. Though some falls can result in serious injuries such as fractures, not every fall results in a significant physical injury. Even without a serious injury, a fall can still cause distress and psychological problems. [2]
The severity of a fall and the existing health of the patient determine the result of a fall. Some serious physical consequences of falls can include death, hip fractures, other fractures, broken bones, joint dislocation, lacerations, sprains, and soft tissues injuries. In addition, bruises, grazes, and general pain occurs in most cases of falls. [1]
Whether a fall results in a serious injury or not, there is likely to be a lasting psychological impact on the patient, and even the medical and care professionals around them. Feelings of distress, fear of future falls, embarrassment, lack of independence and general dissatisfaction commonly occur after a fall.
Older patients may become even more distressed after a fall, as they battle with their changing physiology and the affects of ageing. It is important to consider their feelings and autonomy as much as possible. [3]
Risk factors for falls
Falls can happen to anyone, however, some patients are at a greater risk than others. The Journal Article: Prevention of falls in hospital explains that the majority of falls are not true accidents. Furthermore, falls are not an inevitable consequence of getting older. In fact, they are a combination of several intrinsic and extrinsic risk factors brought together. Not all falls are preventable, but they are not all inevitable either.
The causes of falls tend to be multifactorial, with many separate factors contributing to a higher falls risk. In most cases, there is no one “main” factor that causes a fall. [4] There are several known factors that influence the risk of falls, that have been observed in many cases over the years. Factors such as advanced age, male sex, a previous recent fall, mobility issues, recent surgery, poor vision, confusion or delirium, muscle weakness, urinary incontinence or frequency, and reactions to medication. [3] [4]
Lifestyle and behavioural tendencies can also impact the risk of inpatient falls. For example, an elderly patient with instability and mobility issues may not feel ready to give up their independence. They may choose to walk to the shops regularly, or live in a home with stairs, increasing their likelihood of having a fall. When we consider the risk factors for fall, it is important to apply an all-round approach to each patient, and treat them individually.
Preventing falls in hospital
There is no one way to prevent inpatient falls. The individual risk factors, pre-existing health conditions, length of hospital stay, amongst other considerations all play a role in a successful falls prevention plan.
Knowledge and education are key to preventing as many falls as possible. For example, knowing that over 3 million people in the UK have osteoporosis and face a greater risk of fragility fractures, or that over 10 million people are currently aged 65 and over in the UK, can help you grasp the general populations risk of experiencing a fall. [2]
The Royal College of Physicians have created an excellent resource for preventing falls in hospital. They share some suggestions for actions that can be completed on the wards to prevent falls. These are:
- Safe footwear should be worn.
- Call bells should always be in reach of a patient.
- Tests should be made to check for dementia or delirium.
- Blood pressure should be measured when lying and standing.
- Patients who need walking aids should be able to reach them.
- All patients should have a vision assessment whilst in hospital.
- Patients who have continence issues should have a plan in place.
- Patients with delirium and dementia should have a special care plan.
- Patients should have their medication reviewed and changed if appropriate.
- Immediate bedside environments should be clear from clutter and hazards.
For more information, you can read the full guide: Falls prevention in hospital: A guide for patients, their families and carers here.
Falls prevention socks
Falls prevention socks, or “hospital socks” are a common method of preventing falls in hospitals and care facilities. They feature a tread underneath the foot, as well as on top of the foot. This tread has a rougher texture than the socks, allowing it to better grip surfaces like hard floors and tiles. Using this type of tread reduces the risk of the patient falling when walking or standing.
In recent years, a bright yellow colour has been adopted for these socks. This colour was chosen to provide a striking visual indicator of patients who are at a higher risk of falling, making them more easily seen when on the wards. Nurses and carers can quickly identify those at a higher risk, and provide them with the necessary aids and support to walk safely in hospital.
Trusts across the UK have been using our Falls Prevention Kit. The kit includes a pair of non-slip hospital socks, as well as flame retardant fleece blanket, both in the bright yellow colour. The addition of the blanket provides an even greater visual indication of high risk patients than the socks do alone. Plus, the blanket is a comforting resource for patients.
Get in touch
If you are interested in our falls prevention products, you can purchase them online and benefit from bulk discounts. If you are looking for purchase for an NHS Trust or hospital, you can purchase our falls prevention socks and falls prevention kits via NHS Supply Chain, in packs of 20, or 100.
For queries or bespoke requests, get in touch with Business Development Manager Monika Stosik, who has worked on falls prevention projects in Trusts all over the UK.
Sources
- The Second Fifty Years: Promoting Health & Preventing Disability
- Falls: Applying all our health
- Prevention of falls in hospital
- Prevention and Management of Adult Inpatient Falls
- Falls prevention in hospital: A guide for patients, their families, and carers
- Inpatient falls and pressure ulcers
