National safety and quality requirements

The National Safety and Quality Health Service Standards describe the actions needed to keep patients safe and provide quality care.

Standard 5: Comprehensive Care outlines the following specific requirements for preventing falls:

  • 5.24 The health service organisation providing services to patients at risk of falls has systems that are consistent with best-practice guidelines for:
    • falls prevention
    • minimising harm from falls
    • post-fall management.
  • 5.25 The health service organisation providing services to patients at risk of falls ensures that equipment, devices and tools are available to promote safe mobility and manage the risks of falls.
  • 5.26 Clinicians providing care to patients at risk of falls provide patients, carers and families with information about reducing falls risks and falls prevention strategies.

National best practice guidelines

View the national Best Practice Guidelines for Preventing Falls and Harm from Falls in Older People on the Falls prevention page of the Australian Commission on Safety and Quality in Health Care website.

SA Health Fall Injury Prevention and Management Clinical Guideline

The SA Health Fall Injury Prevention and Management Clinical Guideline (PDF 369KB) outlines the scope, principles, definitions and responsibilities for effective falls prevention systems across SA Health.

SA Health Fall and Fall Injury Prevention and Management Toolkit

The SA Health Fall and Fall Injury Prevention and Management Toolkit comprises the following:

Tool 1 - Example Terms of Reference (TOR) for a health service’s Fall Prevention Committee

The Example TOR (PDF 84KB) illustrates how such a committee can lead activities to improve care, reduce risk and meet national safety and quality health services standard requirements.

Tool 2 - When and how to do fall risk screening, assessment, care-planning and discharge planning

When and how to do fall risk screening, assessment, care-planning and discharge planning (PDF 139KB) provides recommendations for these aspects of care, including consumer and carer input.

Tool 3 - Safe use of bed rails

Safe use of bed rails (PDF 186KB) assists SA Health staff to:

  • minimise the use of bed rails by using alternative strategies
  • minimise any potential harm from unsafe use
  • identify when the use of bed rails constitutes a restraint
  • when the incident requires reporting into Safety Learning System (SLS).

Tool 4 - Reporting a patient fall incident into SLS – Topic guide

Reporting a patient fall incident into SLS topic guide (PDF 92KB) contains key details for notifying falls incidents and should be read in conjunction with Tool 5.

Tool 5 - Reporting a patient fall incident – frequently asked questions (FAQs)

Reporting a patient fall incident FAQs (PDF 373KB) provides illustrative scenarios and examples to clarify when and how to report a fall.

Tool 6 - Post fall team review

Post review flowchart (PDF 55KB) is used to guide investigation and review by the clinical team after a consumer fall. It describes the process for a clinical team review within two days of a serious or repeat fall. This quick process will enable the review of many fall incidents, and improvement of consumer and service safety in a timely fashion, with reduced repeat falls.

In the managers page of Safety Learning System (SLS) there is a section to record the outcomes of a post fall review. SA Health managers can use this to easily generate reports of these actions.

A demonstration video of a post fall team review taking place is available for SA Health staff in the Falls Prevention eLearning course.

Falls risk screening, assessment and care planning

Risk screening, assessment and care planning are foundational practices for health professionals to prevent falls and minimise harm from falls.

Staff should use the SA Health MR 58 forms (for adult use) or EMR/community equivalents as part of everyday clinical practice.

Videos and information about using the following forms is included in the SA Health Falls Prevention eLearning course (see below).

Staff should consider Tool 2 - When and how to do fall risk screening, assessment, care-planning and discharge planning (PDF 142KB).

Minimising harm from falls

Minimising the harm caused by falls can significantly improve consumer recovery and health outcomes.

Support consumers to have a healthy balance of food, fluids, and mobility at home and while in hospital. Patients with cognitive impairment may need help with these tasks.

Make small changes to your patients’ surroundings for big impacts to minimise risk:

  • While in hospital orientate the patient to the call bell and provide a regular toileting routine if required.
  • Keep items such as drinks, food, TV remotes, glasses within easy reach.
  • Declutter and ensure adequate lighting.
  • Have the right equipment available such as walking aids, sensor mats or poles, fall mats and shower chairs.
  • Ensure safe and well-fitting shoes are worn. Non-slip socks are only to be used as part of an individualised care plan developed after a comprehensive risk assessment.

Patients with a cognitive impairment can fall from a significant height if climbing over a bed rail, resulting in fracture or head injury. Use the Bed Rail matrix (PDF 196KB) to understand the level of risk for your patient. Remember to include allied health, the medical team and the patient’s family in decisions about bed rails.

A patient review with a multi-disciplinary team, or a repeat home risk assessment, before and after the first fall is more likely to minimise harm in the future and prevent subsequent falls.