This article is part of our Training Requirement Series where we provide comprehensive guides to meet the actual training requirements that are often needed/requested of learning and development departments within Australia's healthcare organisations. This series includes both general requirements, such as falls prevention, but also focuses on the specific requirements stemming from the NDIS, Aged Care and NSQHS Quality Standards.
What Are Falls?
Falls refer to instances where an individual unintentionally comes to rest on the ground, floor, or another lower level. It is often the result of a complex interplay of risk factors, including environmental hazards, physiological factors, and medication effects.
What is the Falls Prevention Training Requirement?
In line with NSQHS standards, particularly the comprehensive care standard, healthcare organisations must implement appropriate training programs targeting falls prevention:
Relevant Standard
Action 5.24: Regularly educate healthcare providers.
- This action calls for healthcare organisations to regularly educate and train their healthcare providers on falls risk assessment and prevention. The educational programmes should cover the identification of risk factors, preventative measures, and the correct procedures to follow if a fall occurs. Training can take various forms including workshops, online modules, and practical exercise
Action 5.25: Screen and assess fall risks during admission and routinely.
- Healthcare providers are required to screen all patients for their risk of falling upon admission and throughout their stay, especially after any change in medication or clinical status. This involves using standardised risk assessment tools and scales to quantify the risk of falls. Healthcare staff should be trained in utilising these tools effectively.
Action 5.26: Implement and monitor effective prevention strategies.
- This action specifies that once risks are identified, evidence-based prevention strategies should be developed and implemented. This includes multifactorial interventions such as adjustments to the physical environment, optimisation of medication, and patient education. Staff should be trained on how to implement these strategies and routinely monitor their effectiveness.
National Safety and Quality Health Service (NSQHS) Standards
Action 5.5.3: Falls management processes
The provider implements processes to minimise falls and harm from falls by:
- a. maximising mobility to prevent functional decline
- b. delivering effective and timely post falls care when required
- c. monitoring falls and injuries and review the reason for and consequences from falls
- d. facilitating access to relevant health professionals when required.
Strengthened Quality Standards framework analysis - Aged Care Quality Standards
Failure to comply with the requirements could lead to an organisation being penalised or reprimanded.
How Prevalent are Falls in Healthcare?
Falls are a significant issue in Australian healthcare settings, with approximately 77% of hospitalisations among people aged over 65. (Australian Institute of Health and Welfare, 2020).
Breakdown of falls locations in people age 65+.
As per the above chart, 74% of falls in people aged 65+ occur within their home or aged care facilities. Based on this information, it's evident why this falls prevention standard was put in place.
How to Assess Staff Competency in Falls Prevention
Healthcare providers should be encouraged to undertake self-assessment exercises that test their knowledge and practical skills in falls prevention. These can be facilitated through online modules integrated into your Learning Management System (LMS).
- Objective Assessments:
Written exams, quizzes, or simulations can be administered to evaluate the healthcare provider's theoretical understanding of falls prevention. This could include questions based on case scenarios, risk factors, and appropriate interventions. - Peer Reviews:
Peer assessment can also provide invaluable insights into the competency of healthcare providers. Structured forms or online platforms can be used to collect peer feedback on an individual’s falls prevention practices. - Case Reviews:
Healthcare providers should participate in reviewing patient cases that involve falls. These reviews should be guided by a multidisciplinary team and focus on identifying what could have been done to prevent the fall and how future incidents can be avoided. - Performance Indicators:
Use key performance indicators (KPIs) specific to falls prevention to measure healthcare providers' performance over time. This can include tracking the number of falls or near-falls, and the effective deployment of preventive measures. - Continuing Education:
Track the ongoing education and training activities undertaken by healthcare providers in the area of falls prevention. Continuing education is a strong indicator of commitment to professional development and competency.
What Skills Do Staff Need to Learn Falls Prevention Skills?
| Skill | Key Elements |
|---|---|
| Risk Assessment |
Staff should be proficient in using standardised tools to assess a patient's risk of falling. This includes understanding factors like medical history, medication, and physical condition. |
| Communication |
Communication skills are vital to ensure that all members of the healthcare team, as well as the patients and their families, are informed about the risks and prevention strategies. Staff should be able to articulate complex medical terms in a manner that is easily understood by all parties involved. |
| Observation |
Staff need keen observational skills to detect changes in a patient's condition or behaviour that could increase the risk of falls. |
| Environmental Safety |
Staff should have an eye for detail to identify environmental hazards that could contribute to falls, such as poor lighting, clutter, and slippery floors. |
| Technical Skills |
These include the correct use of mobility aids, assistive devices, and fall prevention equipment like anti-slip mats and hip protectors. |
| Critical Thinking |
These include the correct use of mobility aids, assistive devices, and fall prevention equipment like anti-slip mats and hip protectors. |
| Response to Incidents |
Staff should know the correct protocols to follow when a fall occurs, including medical intervention, documentation, and incident reporting. |
By supporting staff in developing these skills, they will be better equipped to engage and learn and apply best-practice falls prevention within your organisation.
Strategies to Support Employees improve care for Falls Prevention
Building competency in diversity and high-risk group care is a multi-faceted approach. Below are some strategies to help support employees in this area:
- Mentoring and Peer Support:
Create a mentoring system where experienced healthcare providers can guide newcomers through the complexities of falls prevention. Peer-led seminars and workshops can be invaluable for knowledge exchange and reinforcement of best practices. - Access to Online Resources:
Provide staff with access to reputable online courses, journals, and guidelines. This could be part of your organisation’s intranet or made available through external platforms. Access to digital resources allows for continuous learning, making it easier for staff to stay updated on falls prevention. - Interdisciplinary Team Meetings:
Falls prevention is not just the responsibility of nurses or doctors but involves a multidisciplinary approach. Regular meetings across departments, including physiotherapists, occupational therapists, and pharmacists, can help in the exchange of ideas and update everyone on the latest prevention protocols. - Incident Debriefs:
Whenever a fall occurs, a debriefing session should be held to review what happened, identify gaps in practice, and discuss improvements. Such sessions help in institutional learning and make employees feel that their input is valued in improving patient safety. - Audit and Feedback:
Monitoring and evaluation of falls prevention practices should be regular and systematic. Constructive feedback should be provided to healthcare staff based on these audits, which could further inform training needs.
Sample Training Plan for the Falls Prevention Requirement
Using the above image as an example - The results that require immediate attention are "risk assessment skills", "technical skills", and "response to incidents".
Based on this, we can develop a training plan to develop staff's skills in these areas off falls prevention. Below is a sample 8-week training plan that can be adapted to your organisation's specific needs.
| Quarter | Topics | Resources |
|---|---|---|
| Q1 | Understanding Risk Factors and Risk Assessment + Responding to Fall Incidents |
|
| Q2 | Technical Skills and Equipment Usage |
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Competency Assessment for Falls Prevention - Example
Staff assessments are essential for organisations and learning managers to perform in order to determine the skill gaps staff have to develop a comprehensive training plan.
Staff Survey - Falls Prevention Competency
-
How frequently should falls risk assessment be conducted?
[Write your response here]
-
What are the three main risk factors for falls?
[Write your response here]
-
Describe one effective falls prevention strategy.
[Write your response here]
-
How would you handle a patient who has just experienced a fall?
[Write your response here]
-
What resources are available for staff to improve their falls prevention knowledge?
[Write your response here]
-
Explain the importance of patient education in falls prevention.
[Write your response here]
-
How do you report a fall incident?
[Write your response here]
Conclusion
Falls prevention is a crucial component of patient safety that calls for comprehensive staff training and an evidence-based approach. This guide has provided a roadmap for healthcare organisations to assess staff competency, establish training programmes, and create a culture of safety. Through collective responsibility and continuous learning, the aim of significantly reducing falls within healthcare settings becomes an achievable goal.
References
- Australian Commission on Safety and Quality in Health, 2023. 'Comprehensive Care Standard'
- Australian Commission on Safety and Quality in Health, 2023. 'Action 5.24 - Regularly educate healthcare providers.'
- Australian Commission on Safety and Quality in Health, 2023. 'Action 5.25 - Screen and assess fall risks during admission and routinely.'
- Australian Commission on Safety and Quality in Health, 2023. 'Action 5.26 - Implement and monitor effective prevention strategies.'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 5.5.3'
- Australian Institute of Health and Welfare. (2020). Falls in Older Australians 2019-2020. AIHW.
