Falls Prevention and Management in Older People
News and presentations from today's Falls Prevention conference chaired by Prof Cameron Swift, Emeritus Professor and Consultant Physician at King's College London.
Prof Swift opened the conference looking at the drivers for falls prevention including a focus on fracture prevention in the early days and now a focus driven by patient safety, he said today the topic is now wider than just those. Prof Swift reflected on NICE evidence up to now with quality standard 86 and a further review currently underway on primary prevention which is due out towards the end of the year, and focuses on primary risk prevention; identifying risk before the falls happen.
Prof Swift discussed how falling in later life is a threat, a cause of injury but it is also a signal of a underlying healthcare problem or need such as the ageing process, suboptimal physical fitness, stable specific impairment, and unstable systemic illness. Prof Swift went on to reflect on the evidence available for falls prevention and intervention and also the negative finding of ineffective interventions.
Prof Swift suggested how the multidisciplinary/multiagency team should feed into a network for falls prevention led by the Consultant Gerontologist or Geriatritian.
Prof Swift said "Falls prevention is contributing to the broader health of older people" and concluded "it's insufficiently implemented but achievable."
Multidisciplinary assessment and delivering individual post fall protocols to care for any older person who has fallen during their stay
Dr Wallace Tan Chair of Falls Group and Consultant Geriatrician Croydon University Hospital NHS Trust
In his trust Dr Tan has achieved good results reducing falls in practice, and has been tasked with reducing falls by another 25% this year. He said the biggest majority of falls are by the bedside, and discussed the interventions put in place to reduce falls including high, low beds (no bedrails) and non-slip socks. He said it is very important that falls prevention is not a nursing issue but an MDT issue everyone should be involved in and concerned about.
Bridging the gap between acute and community falls services including the role of the Falls Therapy Link Worker
Melissa Turner Falls Therapy Link Worker Central London Community Healthcare NHS Trust
In central London, collaboration between acute and community healthcare providers has improved access to community based services for people who report falling and those who are at risk of falls. Partnership between Central London Community Healthcare and two acute hospitals, St Mary’s Hospital and Chelsea and Westminster Hospital, has been developed and sustained over several years. The Falls Therapy Link Worker role was established in order to provide in-reach to the A&E department and Fracture Clinics to identify patients who would benefit from a falls prevention program or bone health management. The post is suited to the skills of a Physiotherapist or Occupational Therapist. Service level agreements allow the post holder to support A&E and Fracture Clinic staff with streamlined community referral processes and to provide regular training and awareness raising activities in the acute setting. The Falls Therapy Link Worker also has a role in the Consultant Led Falls Clinics; at St Mary’s Hospital by advising the team on a patient’s participation in community therapy services, providing therapy assessments and arranging any onward therapy referrals – fast tracking to intervention where possible - and at Chelsea and Westminster Hospital by facilitating referral to therapy when requested.
Broomfield Dignified Throne Toolkit: Preventing falls in hospital toilets and bathrooms
Carrie Tyler Falls Practitioner Broomfield Hospital, Mid Essex Hospital Trust and Angela Wade Professional Development Lead Nurse & Dignity Lead
The Dignified Throne Audit uses a vareity of sample techniques such as observational audit to establish if the toilets have the correct equipment in the right place and in good functioning order. The audit is very interested in the rationale behind staff and patient decision making as to whether to use the toilets and bathrooms or not. Carrie and Angela want to uphold the patients dignity, and promote the normality of using a bathroom and at the same time increase safety by reducing falls. The ethical dilemma also facing staff is when to leave a patient alone, is this promoting dignity? or an act of neglect as the patient came to harm by falling in the bathroom? The Dignified Throne is hoping to answer this too.
Carrie and Angela discussed over coming behaviours, attitudes and bad habits to improve patient safety and reduce harm from falls.
Falls and Mental Health: Reducing falls in older people with dementia
Vicki Leah Nurse Consultant Older People University College London Hospitals NHS Foundation Trust
Reducing falls in people with dementia
People living with dementia are at high risk of falling indeed, it is the most common reason for them to attend the Emergency Department. The reasons why people with dementia fall is multi-factorial and complex however, the cause or causes should be sort and interventions implemented as appropriate. People with dementia are at high risk of delirium which is a common yet overlooked reason for them to fall. A comprehensive plan of care must to be put in place to prevent or limit the extent of delirium. The plan should be person specific, enabling them to meet their needs rather than simply focusing on manage the risk of falling which may result in silent harms.
Also of interest:
Setting up and running an Effective Falls Service
Friday 21 October
Hallam Conference Centre, London
Ward Manager Summit: Developing your skills as an Effective Ward Manager
Wednesday 21 September
Hallam Conference Centre, London
6 July 2016