Introduction: Inpatient falls are an important cause of mortality, morbidity and increased length of stay in hospital and the most commonly reported inpatient safety issue with ∼152,000 falls reported in acute hospitals every year in the UK. Junior doctors are often asked to review patients after an inpatient fall but often lack the confidence and knowledge as to how to approach and manage the patient.
Change strategies: An initial audit found Foundation Year 1 (FY1) trainees' awareness of the trust falls policy is not universal, confidence in assessing a person who has fallen is variable and medication reviews are poorly understood. As a result, it was suggested that training needs to be improved at both undergraduate and post-graduate level. At induction for FY1, training via a presentation on the trust inpatient falls guidelines was delivered. An audit was repeated a month after the teaching had been delivered.
Change effects: Prior to the training 55% of the responding FY1's had received no training in the assessment and management of inpatient falls, this subsequently decreased to only 7% post-intervention. Confidence levels had improved with 58% of individuals rating themselves with average confidence in assessing a falls inpatient compared with the 39% previously. Forty-two percent were now able correctly identify five or more important areas of assessment compared with the previous level of 22%. Ninety percent recognised a medication review as important, compared previously with 72%; however, 80% could not correctly identify all medication related to falls. Following this it is planned that the training will continue in the local trust induction and rolled out to other trainee groups. A post-falls Proforma has been developed and is being piloted at present, a junior doctor guide to falls in has been produced and a medication review process is being developed.
Conclusion: Training on inpatient falls has improved knowledge and confidence in the assessment and management of inpatient falls in FY1 trainees.