falls prevention - a collaborative approach (st mary's hospital)
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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