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 561Osteopenia 465Normal 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

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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

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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

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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

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• 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