2 May 2014 | Reducing Harm from Falls
Leading British patient safety advocate and researcher Dr Frances Healey has held workshops around New Zealand to share knowledge about reducing harm from falls with people in the health and disability sector.
Dr Healey, Senior Head of Patient Safety Intelligence, Research and Evaluation at the patient safety division of NHS England’s nursing directorate, led three regional workshops for people involved in falls prevention in hospitals, residential care and the community during the April Falls promotion. She was brought to New Zealand by the Health Quality & Safety Commission.
She gave updates on falls reduction strategies such as multifactorial assessment and intervention, bed rails, dementia management, signalling and footwear, and encouraged workshop participants to build on work they had already done to reduce harm from falls.
Dr Healey says New Zealand and England have an almost identical age profile and are adopting similar approaches to falls prevention.
“I’ve been impressed by the number of people I’ve met in New Zealand who have shown they are committed to falls prevention in the long term. I’ve seen lots of examples of creative persistence – people who are using small successes to build greater ones,” she says. “I was also struck by just how well many aged residential care staff know and respect the older people they care for, and are using that insight to make truly individualised falls prevention plans.”
Dr Healey endorsed the importance of establishing fracture liaison services in DHBs to find new fragility fracture patients, and believes a proposed national hip fracture database could be a powerful force for improvement.
“If someone goes to hospital after a fall, they’re likely to have their injuries very effectively treated by ambulance staff and at emergency department. But what they also need is to have someone look at their strength and balance, medication, vision, and all the other factors that can lead to a fall in future,” she says.
“Many falls risks are related to underlying health issues. Good falls prevention doesn’t just prevent falls – it also improves quality of life.”
Falls interventions were most likely to be successful when they had support from every level, from boards and CEOs to frontline multidisciplinary staff. Dr Healey said one approach being used in the NHS was short training packages: registered nurses were given eight days of training to give them the skills and knowledge to become falls experts in their units.
She emphasised the need to stay up to date with the latest evidence, work in partnership with older people and their families, develop individualised falls prevention interventions, and encourage mobility. “There is a real risk that an older person discouraged from walking alone rapidly becomes unable to walk alone, and safety has to be balanced with the need for privacy and dignity.”
Falls prevention is long journey with no one big fix, says Dr Healey. “Every successful falls prevention intervention is invisible. We count the people who fall, but not those we’ve protected from falling - so it’s important to celebrate good professional judgement and person-centred care.”
The Health Quality & Safety Commission has referenced some of Dr Healey’s publications for its 10 Topics on preventing falls, part of the falls focus of the Open for better care national patient safety campaign.
The workshops with Dr Healey were held for the South Island Alliance in Christchurch; for the Midland and Central Regions in Wellington; and for the Northern Region in Auckland, in partnership with the First, Do No Harm patient safety campaign.