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Implementing the Falls Quality Standard in Practice

Dr Shelagh O’Riordan, Consultant Geriatrician, East Kent Hospitals NHS Trust will discussed implementing the Falls Quality Standard in Practice at today’s conference. Shelagh discussed in depth:

  • implementing the quality standard in practice: where to start
  • how do you monitor adherence to the quality standard
  • an update from the Falls and Fragility Fractures Audit Programme

Dr Shelagh O’Riordan talked about the current evidence base for falls prevention using case based examples. She update deleagtes on the recent NICE Clinical Standards published in April 2015 and she will asked delegates to review their service or the service they refer to against these standards.

Dr Shelagh O’Riordan also gave an update of the recent falls prevention in hospital audit.

Dr Shelagh O’Riordan full presentation is available for download at the end of this page.

In her presentation Dr Shelagh O’Riordan Stated:

“Ask yourself the question “Does the service I run/refer to offer these key interventions?”…What can I/we do to improve the service?”

Quality Standards 1, 2 and 3

  1. Checks for injury after an inpatient fall
  2. Safe manual handling after an inpatient fall
  3. Medical examination after an inpatient fall

“Follow NICE guidelines for head injury (note: unwitnessed fall- assume head injury in over 65y)”

“How do we ensure we are compliant? Audit against your post fall protocol, Not currently included in RCP audit, Quality improvement projects, No easy answers/quick fixes!, Repeat your audit/improvement cycle again and again!!”

“Quality standard 4 - Older people who present for medical attention because of a fall have a multifactorial falls risk assessment (MFRA)”

What is a MFRA and what isn’t it? It is NOT a tool to see if you need to do anything!, An assessment with multiple components that aims to identify a person's risk factors for falling and…An intervention with multiple components that aims to address the risk factors for falling that are identified in a person's multifactorial assessment”

How to implement? Everywhere an older person presents, A and E, Minor injuries, GP practice, DN visit, Ambulance staff, Carers visit etc etc”

“Where are you responsible for? Get your own house in order, Visit places where it’s working, Aim to train many to deliver a little rather than a few to do it all!, Commissioners have a responsibility to work with clinicians to see and commission the whole service”

“Quality Standard 5 - Older people living in the community who have a known history of recurrent falls are referred for strength and balance training.”

What is strength and balance training? Exercise must provide a moderate/high challenge to balance, Sufficient exercise dose (50 hours) over 3 months, Ongoing exercise, Brisk Walking should not be prescribed to high risk individuals, Tai Chi an option”

“Quality statement 6 - Older people who are admitted to hospital after having a fall are offered a home hazard assessment and safety interventions.”

“NICE QS - Look after patients who fall safely, Offer MFRA and intervention, Strength and balance training classes or 1:1 and Home hazard assessment”

“In summary…Time to do a “gap analysis”…Good evidence base for reducing falls…Not everything suits everyone…95% hip fractures occur as a result of a fall and preventing falls works!!”

Dr Shelagh O’Riordan Biography:

Shelagh O’Riordan is a consultant geriatrician in East Kent Universities Foundation Trust. She is the clinical lead for East Kent Falls and Fracture Prevention Service which was set up in 2004. She runs multidisciplinary falls prevention clinics and complex osteoporosis clinics for all ages.

She is the Clinical Lead for the Royal College of Physicians Falls Audit Programme and is currently leading the audit on falls prevention on the ward.

Download: Dr Shelagh O"Riordan full presentation

9 July 2015


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