Five Hills Health Region

Falls Prevention in Home Care

Apr 21, 2023 Saskatchewan Falls Collaborative 2

BackgroundSite:

•Moose Jaw Union Hospital

Team:

•Home Care and Community Therapies

Patient Population:

•Home Health Service Clients, Team 1 and 2

Rationale:

•These clients receive more long term service that typically involves personal care support

•Higher needs client base, higher risk for falls

Apr 21, 2023 Saskatchewan Falls Collaborative 3

AimPurpose:•To decrease falls by 20% or more by March 2010

Goals/Objectives

•To have 100% of falls reported to Client Service Managers

•To establish a process to identify at risk clients

•To ensure that all at risk clients have falls prevention intervention

Boundaries:

•Exclude Team 3 home services clients

Aim

• Challenges:

- Identifying that falls have occurred

- Documenting/tracking of falls reports

- Communicating falls between disciplines

- Implementing timely falls interventions

Apr 21, 2023 Saskatchewan Falls Collaborative 4

Apr 21, 2023 Saskatchewan Falls Collaborative 5

Team Members• Home Care

- Pauline Osemlak, DNS (Team Leader)

- Tracey Macfarlane, RN

- Corrie Hordick, HHA

- Jennifer Erbach, HHA.

• Community Therapies

- Lisa Benson, PT

- Dana Philipation, PT

• Team Sponsor

- Bert Linklater, EDCC

Apr 21, 2023 Saskatchewan Falls Collaborative 6

Results1. BERG Score Analysis

From the analysis (wilcoxon & sign tests) there is a significant difference between initial scores and FU scores.

Results2. Falls rate per 1000 (%)

Apr 21, 2023 Saskatchewan Falls Collaborative 7

Results3. Percentage of falls causing injury (%)

 

Apr 21, 2023 Saskatchewan Falls Collaborative 8

Apr 21, 2023 Saskatchewan Falls Collaborative 9

Changes Tested1. Cards clipped to name tags:

Ask these 3 questions before you leave a client’s home:•Have you had a slip, trip or fall since I last saw you?

•Do you have your lifeline or phone with you?

•Do you need anything before I leave

(above on the front, below on the back)

•Prevent Falls: Keep your clients safe in their homes!

•Asking these simple questions will reduce risk of falls and injury due to falls.

•Look for environmental hazards and encourage clients to reduce these hazards.

•Remember to report all falls to your supervisor.

2. Falls Records Doc Book and tracking by Client Services Managers

DATEOF FALL

TIME OF FALL

LOCATIONOF FALL

INJURY CODE1,2,3,4 SEE

BELOW DESCRIPTION OF EVENT

REPORT TO SUPERVISOR

DATE,TIMEINITIAL ACTION/TEACHING

Definition of Fall An event that results in a person coming to rest inadvertently on the ground or floor or lower level, with or without injury. INJURY CODE: Code 1 - No injury. Code 2 - Minor Injury. Requires basic first aid or short term monitoring. (e.g. skin tear, bruise) Code 3 - Adverse outcome. Major injury. (eg. Fracture, head trauma, ER assessment, admission to hospital.) Code 4 - Tragic incident. Death.

HAVE YOU HAD A SLIP, TRIP OR FALL?

NAME:FALL RECORDHSN:

CLIENT NAME DATE OF FALL LOCATION OF FALL INJURY CODE

19-Sep-11 Home 1

16-Sep-11 Home 1

04-Oct-11 Daughter's home 1

07-Oct-11 Home 2

Oct 6 & 7, 2011 Home 2

12-Oct-11 Home; fell out of bed (side rail in place) 2

06-Oct-11 Slipped in shower; didn't completely fall 1

20-Oct-11 In home 2

07-Sep   1

01-Sep fell in living room 1

Oct 8-11 at families in Saskatoon-fell a few times 2

30-Oct at home-visit to emerg 2

29-Oct-11 home 1

Oct. 30, 2011 bedroom 2

25-Oct-11 getting into medi chair 1

01-Nov-11 getting out of bed, slipped on rug 1

01-Nov fell in bathroom-Bentley staff helped her up 1

07-Nov fell in bathroom-Bentley staff helped her up 1

Nov. 7 fell in livingroom, missed chair 1

07-Nov fell in apartment, HHA arrived and sent by ambulance to hosp 2

Nov 8-fell 3-4 days ago fell in apartment. 1

31-Oct fell in apartment no injury 1

Nov. 16 apartment 2

Nov. 20 apartment 1

3. Community Therapies Falls Prevention Tracking

Client Name Initial Berg Score

Date # of PTA visits

F/U Berg Score Date Comments

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

             

4. Community Therapies Falls Prevention Algorithm

Apr 21, 2023 Saskatchewan Falls Collaborative 13

Five Hills Health Region

Community Therapy

Falls Prevention Program

5. Presentations:To Home Health Aids, Moose Jaw EMS,

ER department at MJUH

6. Moose Jaw EMS referral process

• Refer all clients with mobility impairments that you do not transport

• Referral process:– Write in instruction area

that info has been given to Therapies

– Ensure client signs form– Fax to Therapies

694-8710

Apr 21, 2023 Saskatchewan Falls Collaborative 16

Lessons Learned

• Communication is key

• Need a process to deal with volume of referrals/amount of falls

• Falls prevention requires ongoing support from many disciplines and agencies:

- Quality Improvement - Epidemiology

- Primary Health Care - Home Care

- Access Centre - Therapies

- Physicians - EMS/ER

Apr 21, 2023 Saskatchewan Falls Collaborative 17

Next Steps• Review data collection processes

• Formally track the volume of falls referrals to Therapies from all sources: ER, EMS, Home Care, Access Centre, inpatient wards, self/family, physicians.

• Connect with Primary Health Care and the Falls Steering Committee?

• Presentations to local physicians?

• How do we implement timely interventions with the same amount of staff?