Change is brewing: Simple switch to decaf sees patient falls halve

A simple switch to a decaf cuppa has nearly halved patient falls in a couple of Elderly Care Wards at the Royal Berkshire Hospital. The figures are the result of a six-month pilot into toileting-related falls and clinicians are now looking at rolling it out to other inpatient wards at the Reading hospital, which has the potential to save thousands of pounds and keep patients safe while in hospital.

The pilot saw the wards provide decaffeinated drinks as the default, with caffeinated drinks available on request. It followed on from a positive ‘taste the difference’ challenge testing patients’ opinions on decaffeinated options of tea and coffee. Clinicians in Elderly Care were keen to see whether something as simple as changing what patients drink could help tackle some factors that make falls more likely, and the results show a 47% drop in toileting-related falls. Staff on the wards also reported an improvement in the number of toileting requests, agitation, and sleep.

Caffeine is a diuretic and can irritate the bladder, increasing the urgency and frequency of urination. This leaves patients feeling like they need to rush to the toilet, with some not waiting to be helped. This, combined with being in an unfamiliar environment, unsteady on their feet or unwell increases the likelihood of them falling. It can also increase the need to urinate at night and as a stimulant it can disrupt sleep, leading to falls from being over-tired.

As well as keeping patients safe, the additional cost to the NHS after a single fall while in hospital can be up to £2,600, and a fall causing a fracture can cost the NHS up to £14,000. During the pilot alone the Trust avoided nearly £25,000 in associated costs and up to 90 ‘bed days’ with studies showing that a fall while in hospital can add more than a week to a hospital stay.

Katie Oliver, Royal Berkshire NHS Foundation Trust Falls Clinical Specialist Practitioner, said: “Sometimes it is the simple changes that can make a big difference. Tea and coffee are part of the rhythm of life on the wards during a hospital stay. Changing the default to decaf was a straightforward, low-cost step we could try out.”

“We have seen a really encouraging reduction in toileting-related falls. Keeping our patients safe is at the heart of this project, especially for our patients who may be older or more frail, a fall can be a significant hurdle to overcome, both physically and confidence-wise. This work goes to show how looking differently at every aspect of the care we provide is worthwhile, even the ones we are most used to” she added.

This work builds on a study carried out by University Hospitals of Leicester NHS Trust who shared their experience with the team at the Royal Berkshire NHS Foundation Trust.