National Audit of Inpatient Falls 2017

The National Audit of Inpatient Falls (NAIF) is designed to capture data from acute, community and mental health hospitals relating to falls, and is based on NICE guidance and advice from NHS Improvement (NHSI).

Hospital inpatients in England experienced a quarter of a million falls during the year 2015/16.1 These
were spread across acute, community and mental health hospitals. Falls are commonly reported patient
safety incidents and result in:
 over 2,500 hip fractures2
 loss of confidence and slower recovery, even when physical harm is minimal
 distress to families and staff
 litigation against hospital trusts
 overall costs to hospitals of £630 million per year.

Acute illness, particularly in frail older people or those recovering from serious injury or surgery,
increases the risk of a fall in hospital. Patients are vulnerable to delirium, dehydration and
deconditioning, all of which affect balance and mobility, especially in unfamiliar surroundings. The
majority of falls occur among medical inpatients during the first few days after admission.
These circumstances mean that not all falls are preventable. However, successful implementation of
guidance from NICE may prevent 20–30% of falls.4 Prevention depends upon prompt assessment to
identify potential risk factors, followed by clinical responses to ameliorate their effects. This is a complex
task requiring a multidisciplinary team approach. One patient may require several individually tailored
interventions. It also requires a patient safety approach throughout the organisation, with practical
support such as walking aids being always available, a culture of reliable incident reporting, and clear
accountability and commitment from senior leaders.

The National Audit of Inpatient Falls (NAIF) was designed to capture all these elements. It is based on
NICE guidance and advice from NHS Improvement (NHSI).

国家住院患者跌倒审计（NAIF）旨在收集来自急性、社区和心理健康医院的与跌倒相关数据，该审计基于英国国家卫生与临床优化研究所（NICE）的指导方针以及国家卫生服务改进局（NHSI）的建议。在2015/16年度，英格兰的住院患者经历了约25万起跌倒事件。这些事件分布在了急性、社区和心理健康医院中。跌倒事件是常见的患者安全事件，其后果包括：
超过2,500例髋部骨折2
信心丧失和恢复迟缓，即便身体伤害微乎其微
对家属和工作人员的困扰
针对医院信托机构的诉讼
医院每年总计6.3亿英镑的成本。
急性疾病，尤其是对于脆弱的老年患者或正在从严重伤害或手术中恢复的患者，会提高他们在医院中跌倒的风险。患者易受谵妄、脱水和脱适应症的影响，这些都影响平衡和活动能力，尤其是在不熟悉的环境中。大多数跌倒事件发生在患者入院后的前几天。这些情况意味着并非所有跌倒事件都可以预防。然而，成功实施NICE的指导方针可能预防20-30%的跌倒事件。预防依赖于及时评估以识别潜在的风险因素，随后通过临床干预措施来缓解其影响。这是一项复杂的任务，需要多学科团队的协作方法。一个患者可能需要多个个体化的干预措施。此外，还需要在整个组织中实施患者安全策略，包括始终可用的实际支持（如步行辅助工具）、可靠的意外事件报告文化，以及高层领导清晰的问责制和承诺。
国家住院患者跌倒审计（NAIF）旨在捕捉所有这些要素。它基于NICE的指导方针以及国家卫生服务改进局（NHSI）的建议。