Driving improvement through national guidance, national and local audit
Professor Cameron Swift, Emeritus Professor, Consultant Physician & Specialist Committee Member, Falls Prevention Quality Standard, NICE
DRIVING IMPROVEMENT THROUGH NATIONAL GUIDANCE, NATIONAL & LOCAL AUDIT
National Guidance on falls prevention (CG 21, CG161; QS 86) has been available since 2004. Additional evidence (previously absent) for the modest effectiveness of multifactorial interventions in inpatients underpinned the 2013 CG161 update. In spite of this, national audits continued to indicate unacceptable variation and deficiencies in the commissioning, organisation and delivery of care.
This presentation will briefly cover the following:
1. A recap review of the phenomenon of falls in older people
2. The evidence underpinning its prevention in high risk groups, of whom inpatients constitute the highest
3. Interventions that have been shown to be either effective or ineffective
4. The development and content of National Guidance on this topic
5. The concept and opportunity of national and trust-level audit of inpatient fall prevention
6. Findings of the 2017 RCP National Audit of Inpatient Falls
7. Forward recommendations for progress, implementation and the need for further research.
Falls and Delirium: Reducing Falls associated with Delirium
Dr Mani Santhana Krishnan, Consultant in Old Age/Liaison Psychiatry & Associate Clinical Director, Tees, Esk and Wear Valleys NHS Foundation Trust
Academic Secretary, Royal College of Psychiatrists Faculty of Old Age Psychiatry
Dr Krishnan is passionate about promoting Delirium awareness to health care professionals and Public. He has been actively championing Delirium prevention in the North East of England.
Recently he also has been spreading the Delirium Education internationally. He has presented his work on delirium education in national and international conferences.
He is active in promoting delirium awareness in social media and started the hashtag #icanpreventDELIRIUM.
His #DeliriumReady campaign had a global reach on the World Delirium Day in March 2019.
"Dictionary definition of delirium – to leave/move away from normal track. Need to understand history of patient – any changes to normal Increased distress – patients, relatives, staff Delirium must be taken as seriously as other organ failure – this is brain failure. On a general ward 20% of older adults present with delirium; this increases to 80% on ICU Worsens existing dementia. Delirium burden - occurrence has remained at 23% for 40 years Failure to have a delirium programme is a missed opportunity in falls prevention. Spreading awareness has increased engagement in delirium over past 4-5 years. Social media has been key - #IcanPreventDelirium ; #DeliriumReady ; World Delirium Awareness Day Various tools to detect delirium – 4AT; freely available no license. Delirium is common & carries very high mortality rate."
Using individual multidisciplinary assessment and assessment tools
Dr Anne Davies, Consultant Geriatrician & Falls Lead, Royal Free London NHS Foundation Trust
The complex and evolving process of falls prevention in hospital will be discussed. Development of a falls assessment tool, with associated barriers and successes will be described. Detail will be given on specific assessment tools within the assessment. The talk will address post fall analysis, with a view to preventing further falls in an individual, and to for the purpose of general learning.
Full PowerPoint Presentation