Practice Guidance. Suspected Minor Head Injury Guidance Adults Operations. West Sussex County Council Adults Operations Provider Services

Transcription

1 Adults Operations Practice Guidance West Sussex County Council Adults Operations Provider Services Version: 1.0 Effective from: 28 March 2018 Next review date: 28 March 2021

2 Document details Prepared by: Project: West Sussex County Council Adults Operations Version: 1.0 Status: Ratified Date: 28/03/18 Scope: Author: Owner: Social care; adults; health and safety, risk assessment Vanessa Keen, Quality Assurance Lead Provider Services, Tracie Thomas, Head of Safeguarding and Adult Social Care Document history Version Date Author(s) Details 1.0 Vanessa Document creation Keen Document signoff Tracie Thomas, Head of Safeguarding and Adult Social Care April 2018 Feedback: Our customers expect first class service and we aim to provide it. If you have any comments about this document please Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 2

3 Contents Page 1. Overview 4 2. General Health and Safety 4 3. Support/Care Plans/Risk Assessments 4 4. Guidance if a minor head injury is suspected 4 5. Records 5 6. Training 5 7. Performance Measures 6 8. Supporting Documents 6 Appendix 1 Home Hazard Checklist 7 Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 3

4 1. Overview The National Institute for Health and Care Excellence (NICE) Clinical guideline 176 states Annually, about 200,000 people are admitted to hospital with head injury. Most people recover without specific or specialist intervention, but others experience long-term disability or even die from the effects of complications that could potentially be minimised or avoided with early detection and appropriate treatment. 2. General Health and Safety All staff must be vigilant regarding any potential hazards and risks that may be associated with any slips, trips and falls and these must be reported immediately. Managers (or delegated Health and Safety representative) must carry out an appropriate risk assessment (including the physical environment, and risk assessments for each individual). All areas must be regularly checked to ensure slip, trip and fall hazards are minimised. A safe environment should be maintained at all times ensuring that: Routes to toilets, communal rooms, bedrooms etc. are not blocked, Mobility/assistive aids are maintained in a safe working condition. Windows fitted with restrictors (or similar) and are working correctly. Flooring and lighting checked. 3. Support/Care plans/risk Assessments Individual Support/Care Plans should be written and followed in response to risk assessments completed, noting the likelihood/potential regarding any slips/trips/falls. Following any slip/trip/fall incident report must be completed and risk assessments and support plans must be reviewed/updated to reflect any learning. 4. Guidance if minor head injury is suspected following slip/trip/fall This guidance sets out recommendations that must be followed should there be cause to suspect a person may have incurred a head injury following an accident/slip/trip/fall. Reassure the person Check for any injuries, call for assistance (if appropriate, contact medical assistance if in any doubt rather than attempt to move the person and bear in mind existing support needs which may present a barrier to the person communicating pain such as dementia, learning disability urinary tract infection etc.) If needed Manual Handling equipment (such as mobile hoist, or Mangar Elk/Camel may be considered. In some circumstances, the person may be able to be shown how to get themselves up from the floor. Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 4

5 Monitor (and record) the person regularly following the fall for the next 48 hours for: a. Signs of amnesia for events before or after the injury. b. Persistent headache since the injury (that is not relived by painkillers such as paracetamol) c. Any vomiting episodes since the injury d. Any irritability or altered behaviour (easily distracted, not themselves, no concentration in things around them, no interest) Make sure the person does not drink any alcohol for 48 hours following a suspected head injury. Make sure the person does not take sleeping tablets or sedatives following the injury unless prescribed by a doctor. If you are concerned call the persons G.P, NHS direct 111 for advice or 999 in emergency. Call emergency services (999) if the person has sustained a head injury and is experiencing the following: a. Unconscious, - or lack of full consciousness (for example problems keeping eyes open). b. Having difficulty (since the injury) in understanding, speaking, reading or writing, loss of feeling in part of the body, problems with balancing, general weakness, any changes in eyesight (blurred or double vision) and problems walking. c. If there is any suspicion of a skull fracture or penetrating head injury (for example, clear fluid running from the ears or nose, black eye with no associated damage around the eye, bleeding from one or both ears, new deafness in one or both ears, bruising behind one or both ears, penetrating injury signs, visible trauma to the scalp or skull). d. Any seizure ( convulsion or fit ) since the injury, or collapsing passing out suddenly. 5. Records Incident form to be fully completed, risk assessments and support plans updated noting any learning. All records must be kept in line with the legal requirements including Data Protection. 6. Training All staff must sign to say they have been made aware of, understand and agree to adhere to this guidance. The Service Manager will keep a record of who has read this guidance Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 5

6 7. Performance measures The effectiveness of this guidance will be measured through recording and monitoring of incident reports. The impact of the guidance is evaluated as part of the quality improvement process, and through 1:1 supervision and appraisal of staff. 8. Supporting Documents Head Injury Assessment Minor head injury factsheet NICE Guidance Head injury: assessment and early management Appendix 1 Home Hazard Checklist Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 6

7 Appendix 1 Home Hazard Checklist Name Identified Hazards Floors Clu t t e r b lo cks w a lk w a ys Worn or loose fitting carpet Loose mats / rugs on floor Long pile carpet Trailing leads Date of Birth Date of Assessment Action/Comments Stairs & Steps Steps/thresholds between rooms Steps at back / front door In s u fficie n t s t a ir ra ils Environment Inadequate lighting where? Curtains difficult to pull Doors difficult to open / close Access to cupboards / wardrobes Kitchen cupboards items too high / low Slippery bath or shower tray/floor Low fitted sockets / switches Telephone or entry phone out of reach Pets Access to property or m ain entrance Furniture Exce s s ive fu rn it u re Too low / high In a p p ro p ria t e e.g. s w ive l ch a irs Individual Poor footwear Tra ilin g clo t h e s Inadequate / inappropriate mobility aids Other Copyright West Sussex County Council / Version 1.0 / 28 March 2018 Page 7