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Sherwood Forest Hospitals NHS Foundation Trust introduces grab box to every ward as part of ongoing fight to reduce harm from falls

 Sherwood Forest Hospitals   falls grab box web

Sherwood Forest Hospitals’ falls lead nurse Joanne Lewis-Hodgkinson (left) and Julie Hallsworth, deputy sister on King’s Mill Hospital’s acute medical and mental health (Woodland) ward 


August 8, 2016


Sherwood Forest Hospitals are issuing each ward with a dedicated falls grab box as the trust fights to reduce the number of falls and level of harm as a result of falls.

Falls lead nurse Joanne Lewis-Hodgkinson and duty nurse manager Gerry Edwards developed the box to bring equipment and information together in a single place to help make the immediate response to a fall more effective.

The NHS Foundation Trust in Nottinghamshire is now rolling out the falls grab box across its hospital sites – King’s Mill Hospital, Sutton-in-Ashfield, Newark Hospital and Mansfield Community Hospital.

It is the latest move at the trust which has seen a steady decline in the number of falls over the past two years.

The monthly falls with harm total in June 2014 was 55, the total for May 2016 was 14. The number of falls per 1,000 occupied bed days for the trust (excluding maternity and children’s) has declined from 8.15 in May 2015 to 6.09 in May this year (2016).

“The grab box means equipment and information are easily to hand and in the same place on each of the wards,” says Joanne, a former ward sister with more than 30 years of service with local hospitals.

“But there is no magic wand. This has been achieved through sustained effort and dedication by staff and a commitment to learn from every incident.

“The key has been a series of small and simple steps that have added up to a big difference.”

Changes introduced include:

  • Mobile workstations – referred to as patient stations – introduced so nurses can move to work within direct sight of vulnerable patients
  • Double-grip socks and anti-embolitic stockings – single-grip socks often tended to spin round  while patients were in bed, increasing the risk of slipping when  trying to get out of bed
  • Raising the height of toilet roll holders – patients were at risk of slipping if they had to reach down and sideways for paper
  • Non-slip seat and floor mats, to help prevent slipping as patients get up from vinyl/wipeable chairs
  • Encouraging relatives to replace old and worn slippers
  • Working with community groups to increase awareness of falls and fall hazards to reduce the number of hospital admissions
  • Encouraging activities – including twiddle mitts and games - on the wards. Occupied patients are less likely to become restless and try to get out of bed to walk around.

The trust also has a harm-free care group that meets monthly to review specific falls incident reports and address risks. Members include a range of representatives from the trust, clinical commissioning groups, practice development therapists and pharmacy.  

Monthly learning notices are used to highlight factors that might increase risk. Some are clinical, some are practical, such as how medication might mean a patient needs to go to the toilet more frequently, the benefits of a good night’s sleep, the links between acute illness and delirium, hydration and a good diet.

Many of the changes have been implemented on King’s Mill Hospital’s acute medical and mental health ward – Woodland.

One indicator of the effect this approach of small changes adding up to a big difference was a message from Care Quality Commission inspectors.

The trust has been in special measures since April 2014 and was re-inspected in July this year. After the visit, initial informal comments from the inspection team included that the care and support on Woodland Ward was “amazing”.

What’s inside the new falls grab box

Falls grab boxes are stored in the same place in every ward – alongside the resuscitation trolley, defibrillator and sepsis box.

The box contains:

  • Information on head injuries (quick guide to assessing harm)
  • Pen torch for checking pupil dilation
  • Lifting blankets – to help get patients off the floor, when appropriate
  • Grip socks
  • Swabs tape and gloves.