National Audit of Inpatient Falls 2015

Inpatient falls are common and remain a great challenge for the NHS. Falls in hospital are the most
commonly reported patient safety incidents, with more than 240,000 reported in acute hospitals and
mental health trusts in England and Wales every year (that is over 600 a day). All falls, even those that
do not result in injury, can cause older patients and their family to feel anxious and distressed. For those
who are frail, minor injuries from a fall can affect their physical function, resulting in reduced mobility,
and undermining their confidence and independence. Some falls in hospital result in serious injuries,
such as hip fracture (more than 3,000 per year) and serious head injuries, and these injuries can result in
death. Falls in hospitals are financially expensive, as they increase the length of stay and may require
increased care costs upon discharge. In 2007, inpatient falls were thought to cost trusts alone £15
million, and will be more expensive now.

Tackling the problem of inpatient falls is challenging. There are no single or easily defined interventions
which, when done on their own, are shown to reduce falls. However, research has shown that multiple
interventions performed by the multidisciplinary team and tailored to the individual patient can reduce
falls by 20–30%. These interventions are particularly important for patients with dementia or delirium,
who are at high risk of falls in hospitals.

住院患者的跌倒事件普遍存在，对英国国家医疗服务体系（NHS）构成重大挑战。医院内跌倒是最常见的患者安全事件报告，每年在英国和威尔士的急性医院及心理健康信托机构中，报告的跌倒事件超过24万起（即日均超过600起）。所有跌倒事件，即使没有造成伤害，也可能导致老年患者及其家属感到焦虑和痛苦。对于体弱者而言，跌倒可能导致的轻微伤害会影响到他们的身体机能，进而造成活动能力下降，削弱他们的信心和独立性。一些医院内的跌倒事件会导致严重伤害，如髋部骨折（每年超过3000起）和严重头部伤害，这些伤害可能导致死亡。医院内的跌倒事件在财务上代价高昂，因为它们会延长住院时间，并在出院后可能需要增加护理费用。2007年，住院患者的跌倒事件被认为仅对信托机构就造成了1500万英镑的损失，而如今这一数字恐将更高。

解决住院患者跌倒问题极具挑战性。目前尚无单一或易于定义的干预措施，单独实施能够证明其可以减少跌倒事件。然而，研究表明，由多学科团队实施并针对个体患者定制的多种干预措施可以将跌倒事件减少20%-30%。这些干预措施对于患有痴呆或谵妄、在医院内跌倒风险较高的患者尤为重要。