Hospital policies on falls in relation to patients with communication disability: a scoping review and content analysis

The final literature review from my PhD can be found in the Australian Health Review. 

https://www.publish.csiro.au/ah/AH22289

TLDR: Communication Disability is not often captured as a risk factor for a fall on assessment tools. Limited guidance for staff to adapt falls prevention education for patients with communication disability Limited identified role for speech path in falls prevention or management

Key Findings from the Policy Review

The review of hospital and health service policies revealed several significant findings:

  1. Assessment of Falls Risk: Communication disability is often overlooked as a risk factor in falls risk assessment tools. These tools frequently categorize communication disability under cognitive impairments, such as dementia or confusion. This conflation leads to inadequate strategies for reducing falls in patients with communication disabilities. Fall risk assessment should include identification and documentation of a patient's communication disability, allowing for more targeted and individualised fall prevention strategies.


  2. Prevention of Falls: Many falls prevention plans in hospital settings rely on patients' proficient verbal comprehension skills. Patients with communication disabilities are often left without guidance or adaptations to understand these prevention strategies. Written materials, which are the primary means of conveying information, are often inaccessible to them due to complex linguistic forms and a lack of alternative communication methods. Patients with communication disabilities need tailored approaches that consider their unique communication needs, such as the use of simplified formats, multimodal communication including gestures, pictures, or video modelling.


  3. Role of Family Members and Carers: Hospital policies recommend educating patients and their families or carers about falls prevention. When patients with communication disabilities are unable to participate in this education, the responsibility is often shifted to family members or carers. This approach places a significant burden on family members and carers and may not be the most effective way to ensure patient safety.


  4. Role of Speech Pathologists: Only one policy tool mentioned the role of speech pathologists in falls prevention for patients with communication disabilities. This highlights the need for multidisciplinary teams, which should include professionals who can support better communication for these patients.

Conclusion

Addressing communication disabilities in falls prevention policies is not only necessary to reduce the risk of falls but also to empower patients with communication disabilities to participate in their care and improve patient outcomes. 

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