Post-fall medical examination: a guide for inpatient settings

• To minimise harm to patients from incorrect management after injurious falls.
• To provide a framework for HCPs designated to this role to systematically review patients, and to identify acute medical causes of the fall and resulting injuries.
• To ensure prompt access/referral to ongoing treatment when injury has occurred.
• To reduce variation in post-fall management within inpatient settings.

1. To clarify what constitutes a ‘medical’ examination after an inpatient fall using existing available guidance.
2.   To provide a framework to support a systematic process to help identify acute medical causes of the fall and resulting injuries.
3.   To guide appropriate and timely investigations to diagnose injuries.
4.  To support appropriate transfer to an appropriate site and/or access to prompt specialist input to treat injuries in accordance with current guidance.
5.  To reduce variation in the treatment of injuries and to align as much as possible with guidance and standards applied to patients with similar (non-inpatient-acquired) injuries who present to the emergency department.
6. To provide guidance on training and competencies required to conduct a medical review of inpatient fall. 

This resource is designed primarily for the use of HCPs whose scope of practice includes examining patients who have sustained an inpatient fall, including (but not limited to):

• doctors, especially resident doctors
•  advance nurse practitioners / clinical nurse specialists
•  allied healthcare professionals
• other autonomous practitioners with appropriate level of skills and competency to perform post-fall examinations.

Those with a responsibility for delivering safe and effective care in inpatient settings should be aware of this resource, including:

• Executive and non-executive board members with responsibilities including falls
•  Divisional Clinical Directors and appropriate Associate Medical Directors
• Trust safety and quality leads including falls lead
• Falls steering group members, falls coordinators, falls practitioners and falls champions
•  Clinical leaders including matrons, ward managers and service/departmental leads
•  Education leaders including education and training leads, practice development nurses, moving and handling trainers
•  Patient experience leads
• Those who hold clinical responsibility for patients