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<h3>Background</h3> Falls management and prevention is a top priority healthcare.<sup>1</sup> Research suggests that some nursing staff lack confidence when making clinical decisions regarding the appropriate level of falls supervision.<sup>2</sup> A multidisciplinary falls group was developed with an aim to reduce falls in the hospice setting. The group peer reviewed an existing observational falls assessment tool<sup>3</sup> which was designed for use in the acute setting to consider how the tool would translate into a hospice inpatient setting. This study aims to explore and understand staff confidence and engagement in using the falls early warning score (FEWS), an observational falls assessment tool, in a hospice inpatient setting. <h3>Methods</h3> The study was designed in three phases: Phase 1 - A rapid review of literature was carried out alongside baseline data on falls over the previous 12 months. Phase 2 - An electronic survey of facilitators and barriers to using FEWS on a hospice inpatient unit, followed by semi-structured interviews with some nursing staff. Phase 3 - Adaptation of the FEWS tool according to findings from the survey and interviews. <h3>Results</h3> Eleven (n=11) participants completed the electronic survey. Five (n=5) participants were interviewed Respondents reported high confidence in both reviewing and implementing FEWS. The most common barriers were lack of time, and electronic access to FEWS. From the qualitative data we identified 3 major themes: Education for FEWS, practicalities of access to FEWS and recognised benefits of using FEWS tool in clinical practice. <h3>Conclusion</h3> This study highlights the potential of the Falls Early Warning Score (FEWS) tool to enhance falls management in a hospice inpatient setting Continued education and improved accessibility will be key to embedding FEWS into routine practice and ultimately reducing fall-related incidents in hospice care. <h3>References</h3> National Institute for Clinical Excellence (2019) Web Page Surveillance decision | Evidence | Falls in older people: assessing risk and prevention | Guidance | NICE NHS England (2019) Web Page NHS England » Development of the ‘Avoiding Falls Level of Observation Assessment Tool’ Richardson DA, Dawson D, Henderson E, Monkhouse E. Using afloat (avoiding falls level of observation assessment tool) to assist nurses in setting the correct level of observation for in-patient falls prevention. <i>Age and Ageing</i>, July 2019;<b>48</b>(Supplement_2):ii1–ii10. https://doi.org/10.1093/ageing/afz055.30