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 Injury Prevention and Safe Mobility Toolkit

Tool 1 - 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 129KB) provides recommendations for these aspects of care, including consumer and carer input.

Tool 2 - Safe use of bed rails

Safe use of bed rails (PDF 140KB) 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
  • identify when the incident requires reporting into Safety Learning System (SLS).

Tool 3 - Helping our patients to mobilise safely

Helping our patients to mobilise safely (PDF 1MB) is a 2-page guide on getting patients out of bed and moving, and the terminology used for the level of assistance required.

Tool 4 - Post fall management of adult patients to minimise harm

Post fall management of adult patients to minimise harm (PDF 220KB) is a step-by-step guide for clinical teams to follow in the first minutes and hours after a consumer fall, including immediate response, injury assessment, management planning, and care plan updates to reduce future risk. Tools are provided to support each stage.

Tool 5 - Levels of patient assistance

Levels of patient assistance (PDF 105KB) provides guidance for all staff involved in supervising or assisting patients while they mobilise. It covers engaging with patients and carers to assess the level of assistance required, expectations for communication and documentation, descriptions of assistance and supervision levels, and the responsibilities of staff.

Reporting a patient fall incident

Patient falls - Safety Learning System Topic Guide (PDF 373KB) provides illustrative scenarios and examples to clarify when and how to report a fall.

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 1 - When and how to do fall risk screening, assessment, care-planning and discharge planning (PDF 129KB).

SA Health Falls Prevention eLearning course

SA Health recognises that skilled and knowledgeable staff are essential for the effective delivery of services that aim to reduce the risk of falls and injury from falls during care and across the community.

The Falls Prevention eLearning course is for all SA Health staff involved in direct care and assists in the translation of the national guidelines into practice and to meet accreditation requirements.

The course will enable staff to:

  • recognise the importance of preventing falls and harm from falls
  • identify common risk factors, high risk situations and conditions
  • identify appropriate multifactorial action
  • take action following a fall incident
  • identify actions to engage consumers and carers.

The course contains videos that explain all the SA Health falls prevention tools including screening, assessment, care planning and post fall team review.

The course includes additional resource materials for falls prevention leaders.

The Falls Prevention eLearning course is available to all SA Health employees via iLearn.

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.