Inpatient falls management

Patients who were identified as at increased risk of falling during their admission may continue to be at increased risk of falling after discharge.

In conjunction with the multidisciplinary team, discharge planning should include consideration of referral to outpatient or community services to continue fall prevention efforts at home. Falls risk and falls history should be included in discharge reports and any referrals.

The Older Person Health Network – WA Falls Management Special Interest Group has worked with colleagues across the sector to create two falls prevention health promotion initiatives for hospitals and residential aged care facilities.  

The Move It May campaign reminds clinicians and patients of the importance of reducing deconditioning to support falls prevention. The campaign provides a range of activities and clinical and patient education resources for use in hospital and residential aged care facilities. These messages are consistent with Stay On Your Feet ® messaging in the home and community setting.

The No Falls November campaign focuses on in-hospital falls prevention and health promotion. It’s a time for clinical units to audit compliance with falls related policy, provide health care workers with an opportunity to address gaps in compliance, refresh skills and celebrate high performance. It is also a time to identify and reduce the risk of slips, trips, or falls in clinical settings.

To incorporate best practice and evidence, Western Australian falls prevention and management experts developed the

Falls Risk Assessment and Management Plan (FRAMP) form for standard use in the general adult population in Perth metropolitan hospitals. It is no longer used across all sites but illustrates a systematic approach to the essential screening, assessment and management processes related to falls management. It sets out the minimum interventions  for all patients as appropriate. An evidence table and instructions for how to use the document are included for health professionals. 

The National Safety and Quality Health Service Standards - Comprehensive Care Minimising Patient Harm were developed to ensure patient needs are identified and harm prevented through a focus on integrated care across the patient journey. The 2009 best practice guidelines and guidebook guide provision of care to minimise falls and related impacts in hospitals, the community and residential aged care facilities.

Given the multifactorial nature of falls, a multidisciplinary approach to assessment and management is vital. All professions have a role to play in falls prevention and management.

The Post Fall Multidisciplinary Management Guidelines for Western Australian Health Care Settings 2023 (PDF 895KB) provide evidence-based guidance for use by all health professionals to reduce the risk of further falls and harm from falls. The guidelines promote collaboration within the multidisciplinary team through provision of health professional specific clinical guidelines for post fall care for nurses, doctors, occupational therapists, physiotherapists, and pharmacist..

The Guidelines apply to general adult in-patients who have sustained a fall in any WA  hospital, health service or multi-purpose site.

The Post Fall Multidisciplinary Management Guidelines for Western Australian Health Care Settings were developed and are regularly reviewed and updated by a multidisciplinary group of health professionals from across public, private, and rural/metropolitan facilities in WA, including professionals from diverse cultural backgrounds. Each of the discipline specific guidelines were developed by a discipline-specific group of subject matter experts.

Highlights of the Guidelines include:

• Alignment with the National Safety and Quality Health Service Standards (external site)
• Updated interventions that reflect the latest evidence-based practice
• Additional templates, tools and information. Such as, post fall documentation tools for the patient’s health record and a multidisciplinary falls prevention plan.

• Health advice following a fall (PDF 63KB) | (Word 110KB)
• Educational overview of the Post Fall Multidisciplinary Management Guidelines for Western Australian Health Care Settings 2023 (PPT 2.1MB)
• Western Australian Post Fall Guidelines: Interprofessional Model of Practice Guideline (PDF 149KB) | (DOC 141KB)
• Interprofessional Post Fall Review in Hospital ISOBAR Guide (PDF 84KB) | (DOC 142KB)
• Western Australian Interprofessional Post Fall Review (PPT 2.6MB)
• Occupational therapy educational overview (PPT 1.4MB)
• Physiotherapy educational overview (PPT 1.7MB)
• Pharmacy educational overview (PPT 1.3MB)

WA falls prevention community of practice

Collaboration with staff at other facilities is an efficient way to keep up to date with local patient safety initiatives and projects and reduce duplication when implementing quality improvements. It also provides a means to share the latest evidence-based practice and consult with other specialists in the field.

The WA falls prevention community of practice (COP) for hospital settings is an important group that connects health professionals, researchers, and others from across WA who are interested and/or working in falls prevention. The COP provides opportunities for keeping up to date with patient initiatives, research, and projects, and collaboration on projects. The COP meets quarterly as an open, self-organising, group where members share knowledge and ideas. To contact or participate in the COP please email healthpolicy@health.wa.gov.au.