Standard 10

Preventing Falls and Harm from Falls

NSQHS Standards Standard 10 - Preventing Falls and Harm from Falls

Advisory

This page contains information about the first edition of the NSQHS standards. This edition has been superseded by the second edition that was endorsed by the Health Ministers in June 2017 and released in November 2017.

This latest edition addresses the gaps that were identified in the first edition, including mental health and cognitive impairment, health literacy, end-of-life care, and Aboriginal and Torres Strait Islander health.

Health service organisations will be assessed to the second edition from January 2019.

To find information and resources for the second edition, visit the Australian Commission on Safety and Quality in Health Care's new NSQHS Standards microsite.

Key messages

  1. Falls and related injuries are a major risk to patients in health care settings.
  2. Many falls are preventable.
  3. All clinicians are responsible for falls prevention and the management of falls.
  4. Staff should engage patients and carers in falls prevention plans and in the management of falls should they occur.

Introduction

Fall injuries within hospitals have steadily increased. The impact of falls on individuals is far reaching. The social impact of reduced independence through fear, the potential for loss of independence and the increased burden on families can be significant.

While the risk of falls is well documented for the elderly, falls can occur in all age groups. Therefore, strategies such as screening to reduce falls and harm from falls should not be limited to older Australians. Policies, procedures and protocols for all age-groups need to be based on the available evidence and best practice.

The risk of falls and harm from falls is higher for people with impaired vision, poor balance, muscle weakness, reduced bone density and taking some medications. The more risk factors an individual has the greater the risk of falls and harm from falls. Older people, in particular, are at increased risk of falls when they enter health care facilities. The aim of this Standard is to reduce the incidence, or number, of patients’ falls and minimise harm from falls when they occur.

Facts and Figures

Research shows that, in the face of an ageing population, if nothing is done to prevent falls injuries by 2051:

  1. The total estimated cost of falls-related injury will increase almost threefold from $498.2 million per year in 2001 to $1,375 million per year in 2051.
  2. In hospitals, 886,000 additional bed days per year, the equivalent of 2,500 additional beds, will be permanently allocated to treating falls-related injuries.

To maintain the current health costs associated with falls, there will need to be approximately a 66% reduction in the incidence of falls-related hospitalisations by 2051.

In brief, this Standard requires that:

  • Health service organisations have governance structures and systems in place to reduce falls and minimise harm from falls.
  • Patients on presentation, during admission and when clinically indicated, are screened for risk of a fall and the potential to be harmed from falls.
  • Prevention strategies are in place for patients at risk of falling.
  • Patients and carers are informed of the identified risks from falls and are engaged in the development of a falls prevention plan.

Information above is taken directly from the Safety and Quality Improvement Guide Standard 10: Preventing Falls and Harm from Falls, October 2012 document published in the Australian Commission on Safety and Quality in Health Care website.

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Responsibilities under Standard 10 include:

  • orientate patients and carers to the environment and make it safe
  • screen patients for risk of falling using a validated or best practice tool
  • assess all patients identified as being at risk of falls, to determine individual risk factors
  • use findings from patient assessments to develop an individualised falls prevention plan
  • ensure additional falls risk assessment following:
    • a change in the patient’s environment
    • a change in the patient’s health or functional status
    • a fall
  • implement and evaluate strategies to prevent falls
  • refer patients at risk of falls to a physiotherapist and/or occupational therapist to assist with falls prevention strategies
  • ensure that patients and carers are engaged in falls prevention plans and the management of falls should they occur during hospitalisation and on discharge
  • communicate and document risk status and prevention plans during handover, transfer and discharge.

eLearning modules

Other eLearning resources

Queensland Health iLearn

South Australia Health Digital media eLearning

Available only to South Australia Health employees

Further information

Below is a full copy of the Preventing Falls and Harm from Falls contained in the National Safety and Quality Health Service Standards. It includes the criteria, items and actions required for health services to meet this Standard and is available on the Commission’s website at www.safetyandquality.gov.au.

  • Download Safety and Quality Improvement Guide Standard 10: Preventing Falls and Harm from Falls, October 2012