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Help to prevent falls in hospital

New tool makes for speedy assessment of potential vision problems

Mark Gould

Tuesday, 24 January 2017

A new downloadable tool from the Royal College of Physicians (RCP), that enables ward staff to quickly assess a patient’s eyesight in order to help prevent them falling or tripping while in hospital, is being made available across the NHS in England and Wales.

The College says the Look out! Bedside vision check for falls prevention’ aims to support busy clinical staff in assessing visual impairment in older people.

The tool is not intended to replace expert clinical assessment but the College says it can alert staff to potential concerns that can then be relayed to medical teams for further evaluation.

It uses a mixture of questions and visual aids to help hospital staff check eyesight at the patient’s bedside. Results give an indication of the extent of any visual problems, known or unknown, that the patient may have.

Falls in hospital are the most commonly reported patient safety incidents, with more than 600 a day happening in acute hospitals and mental health trusts in England and Wales every year. Although there is no single cause of falls, poor vision in older people is often related to increased risk.

In spite of this, the RCP’s most recent National Audit of Inpatient Falls revealed that less than half of older patients had a vision assessment when they went into hospital. This is thought to be due to clinicians struggling to find a workable, standardised approach to basic vision assessment that is achievable in an acute hospital setting.

The tool has been created through a collaboration between the RCP and the British and Irish Orthoptic Society, the College of Optometrists, the Royal College of Ophthalmologists, the Royal College of Nursing and NHS Improvement. Frontline staff and patients were involved in its design and testing.

People are deemed as having a visual impairment when their level of vision is below that required to carry out normal everyday activities. Such people are almost twice as likely to fall, and to have recurrent falls and resultant fractures, than people with normal eyesight.

The tool contains:

  • suggested questions to ask a patient to check vision
  • visual tests for distance and near vision
  • information for clinicians about vision conditions common in older people

Shelagh O’Riordan, clinical lead for the National Audit of Inpatient Falls, said: "We believe this new tool will be a very useful resource for all ward staff. It will enable them to quickly and easily identify vision impairment in a patient. This will alert them to an increased falls risk."

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