Falls Prevention - A Collaborative Approach (St Mary's Hospital)

A Collaborative approach to

Prevention of Falls

Daragh Rodger

Advanced Nurse Practitioner

Care of the Older Adult Community

27th February 2014

Report of the

National Steering Group

on the

Prevention of Falls in

Older People and

the Prevention and

Management of

Osteoporosis

throughout Life Falls strategy

2008

Falls Facts and Figures Fact

It is estimated that 30,000 older people attend emergency departments (ED) or Primary Care each year for treatment of fall related injuries.

Fact

Approximately 7,250 older people are admitted to hospital for treatment of fall related injuries every year

Fact

Of those who survive a hip fracture, less than half regain their pre-fracture level of function, less than 50% of people return directly home upon hospital discharge and over 20% need long term care.

Falls facts and Figures

Fact

It is estimated that one in every three people over the age of 65 years and one in two people over the age of 80 years fall every year.

Fact

Falls are the dominant cause of injury in older people where they account for 75% of all injuries

Fact

In 2004 fall related injuries in older people cost €402 million to the economy. By 2020 the cost will be €922-€1077 million and by 2030 the cost will be €1587 - €2043 million.

DXA scan

Bone health assessment

Bone health Education

•Diet

•Exercise

•Lifestyle choice

St Mary’s Healthy Ageing Clinic

Bone Density Results – Healthy Ageing Clinic

0

100

200

300

400

500

600

700

2010

Osteoporosis 561

Osteopenia 465

Normal 621

Bone health through the ages

1-12yrs 13-22yrs Adult Over 80

years

Peak Bone Mass

Age related bone mass Age related bone loss

Bone Health in the Park

10

www.bonehealth.co 11

• Ageing population

• In 2030 a number of the present day work force will

be over 50 years of age

• In 2030 many of us may/will fall and will be a statistic

• Through education we can help reduce these figures

Real Life Facts

12

Impact on Society

• Loss to family and community

• Cost - Overstretched economy

• Provision of services home care, respite care,

extended care

• Proactive approach required rather than reactive

• Education is key

13

FOREVER AUTUMN

Implementation of a falls awareness

programme for all staff – clinical and

non clinical, illustrating the potential for

falls amongst the older adults in our

care.

Elements included:

• Revision of St Mary’s Falls Prevention

and Management Policy

• New Falls Risk Assessment Tool

• New Falls Risk Symbols

• New Falls Reduction Measures

Key Message All staff have a role to play in

reducing the risk of falls – clinical

and non clinical – know your role!

Review of Falls Data from January - June 2013

New Data Measurement Interventions to prevent potential falls Evidence to staff of benefits of Forever Autumn Programme in action

*Compared to falls data pre Forever Autumn in 2011

Phoenix Park Community

Nursing Unit

33% Reduction*

St Mary’s Hospital 15% Reduction*

St Mary’s Community Falls

Service The Falls Service at St Mary’s Hospital is a

consultant Geriatrician led multidisciplinary

service offering the following: – Clinical assessment by Nursing and Medical staff

– Investigations

– Physiotherapy assessment

– Occupational therapy assessment

– Social worker services

– Education & support

Poster Campaign

2013

Prompt patients to ask

about screening for

osteoporosis and will be

placed in key patient

waiting

Areas:-

• A&E department

• Fracture Clinic

• Outpatient clinic

• GP surgery

• Health centre

18

• Forever Autumn has generated a lot of interest from multidisciplinary team members from hospitals and residential units locally and nationally

• Forever Autumn has been implemented by other care facilities

• Forever Autumn is an example of a successful collaborative approach to innovative practice development

• Over 16,450 visits to the web site in 12 months

To promote bone health, falls reduction, falls prevention and effective falls management

To provide a platform to share the

repository of information to the wider community to enhance quality care through presentations, articles of interest, develop special interest groups etc.

Development of an online resource to offer support, guidance and continued education in falls prevention and management across the care spectrum for older adults:- •Acute Hospital Care •Community Care •Intellectual Disabilities Care •Palliative Care •Residential Care

Proactive collaborative approach to falls prevention by providing a platform for continuing engagement

www.foreverautumn.co

www.foreverautumn.co

Reactive V Proactive • System failure – too late to

react at point of hip fracture • Screening - fracture liaison

services currently very poor nationally

• 50% of those who suffered a hip fracture in one site had history of previous fracture with no bone health interventions (O Connor et al 2013)

• Is falls prevention on the agenda???

• Currently national group working towards the implementation of the 2008 strategy

•Bone health – lifelong process need to educate all ages • Increase falls awareness – potential for falls • Falls prevention and reduction across all care settings • Goal is to reach as many as we can in the most cost effective way