Quality Improvement

Reducing harm

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Falls prevention programme

Falls prevention programme

What is a fall?

A fall is defined as “inadvertently coming to rest on the ground, floor or other lower level”.

The "banana man" is a symbol used on patient folders to indicate a patient has had a previous fall, and a magnet is used on the ward whiteboard to indicate an inpatient fall.


What have we done?

Alert monitor

If someone has a high risk of falling and needs assistance to get out of bed, the monitors alert staff and allow for quick response to help prevent a fall

Falls sticker

After every fall, the sticker above is put in a patient's notes to highlight  a fall and record key information

Falls are the second leading cause of accidental or unintentional injury deaths worldwide.  In New Zealand, falls are the leading cause of injury requiring hospitalisation and one of the leading causes of injury resulting in death and 30% of those over 65 years who fracture their hip (neck of femur) will die within 1 year of the fall.

Falls among hospital inpatients are common, on average 106 patients fall per month in North Shore and Waitakere Hospitals. Approximately 30% of inpatient falls result in injury, with 4% to 6% resulting in serious injury.  These serious fall-related injuries include fractures, excessive bleeding, and death. Injuries due to falls also increase health care costs (an additional cost of approximately $27,000 for every hip fracture), and prolong the time patients spend in hospital.

Prevention of falls in hospital is therefore an important patient safety and public health issue.  Waitemata DHB has been working since October 2010 to reduce inpatient falls and has put in place 22 improvements (falls prevention tools) aimed at reducing the number of falls, particularly falls that result in harm. We track the rate of falls, and the rate of falls resulting in major harm each month and share our data and improvement work with the 3 other northern region DHBs (Auckland, Counties Manukau and Northland) as part of the First Do No Harm regional collaboration.

Value: With CompassionSo far we have not seen a significant reduction in the rate of falls and major harm from falls.  In 2013 we have started a new project working with patients most at risk of falling and suffering major harm, and getting a better understanding of which improvements make the most difference [view more about Falls prevention II: zero falls with harm].


Preventing falls brochure for patients and families

A brochure is available for patients and their families with information about how to prevent falls while in hospital
[click on brochure to download a copy]

Patient information poster

The information poster is placed above each bed recording important information for the patient, family and staff to see

April Falls Day

We have an annual April Falls Day to highlight risks associated with falling

Non-slip red socks

Non-slip socks are used for patients who are at risk of falling and those without appropriate footwear

Dr John Scott with a Falls prevention poster
Dr John Scott with a Falls prevention poster


Did we make a difference?

The graph shows an increase in the rate of falls since February 2013.  This is due to an intense monthly review of our falls data by the quality team  and improvements we have made to our reporting system.  As a result we are now able to more accurately identify falls occurring in our hospitals.



First Do No Harm graph displaying the data and how we are tracking our results