Reducing falls through the implementation of a multicomponent intervention on a rural mixed rehabilitation ward

Problem There is an absence of literature to guide staff in how falls can be reduced in a diverse patient population on a mixed acute/subacute rehabilitation unit, especially one with daily fluctuations in acuity that occurs due to frequent changes in its acute/rehabilitation patient ratio. Design Pre-intervention and post-intervention audits. Setting The Rehabilitation Unit at Tamworth Rural Referral Hospital in Tamworth, NSW. Key measures for improvement Improvement in the number of falls and repeat fallers. Strategies for change A multicomponent intervention involving: (a) in-service education sessions for nursing staff about falls risk-increasing drugs, (b) patient and family education regarding falls risks and prevention strategies, (c) improving documentation of incident reports by using a set template, (d) ensuring that the correct patient mobility status information is handed over between nursing shifts and physiotherapists providing timely and regular updates, (e) the introduction of the 'traffic light mobility system' and (f) enhancing the use of existing falls prevention strategies. Effects of change The total falls reduced in number from 36 falls to 19 with a decrease in the number of repeat fallers from 8 to 4. There was also increased compliance with existing falls risk tools and improved documentation of each falls incident which provided insight into activities and times with higher falls risk. Lessons learnt A multicomponent approach remained effective even when applied to a mixed acute/subacute rehabilitation ward setting.