21 Apr 2015 | Reducing Harm from Falls
On 1 April, over 200 health workers attended MidCentral District Health Board’s (DHB’s) falls prevention symposium at the Palmerston North Convention Centre, which was held as part of April Falls activities in the region. Attendees came from across primary and secondary care and included hospital and community nurses, GP teams, allied health including physiotherapists, occupational therapists and pharmacists, home care support workers, students, and representatives from aged care, Central PHO, ACC and Whanganui DHB.
The focus of the evening was the importance of taking an integrated approach to falls injury prevention with an emphasis on footwear and care for safe mobility. Topics covered included an overview of local and national falls prevention campaigns, frailty, medication, podiatry, activity and exercise.
MidCentral’s Nurse Director Medicine, Surgery and Emergency Services, Jan Dewar, says the interest in the evening reflected the fantastic collaboration in the area between the many people who work together to help prevent falls. A significant outcome of this is the collaborative clinical pathway that gives health professionals across the district access to the Falls in Older people pathway through the Map of Medicine.
“Working in an integrated way is a strong focus for us,” says Jan. We have an in-hospital falls prevention group and a community falls prevention group. These groups meet separately, and have a combined meeting every quarter which ensures an integrated approach across the continuum of care.
“Working across specialities and disciplines is really important to ensure you cover all the falls risk factors. The groups include representatives from planning and funding (in relation to vitamin D), public health, ambulance services, aged care, quality and risk specialists, physiotherapy, practice nurses, clinical nurse specialists, charge nurses, occupational therapists, community and hospital pharmacy and ACC; as well as a GP, a senior medical specialist and a nurse practitioner from the Health of Older People’s team.”
Jan says one of the highlights of the seminar was the catwalk ‘fashion show’ with models wearing different types of shoes which the audience were asked to rate in terms of safety, according to the six ‘safe shoes’ criteria.
“It was such a hit that we have developed a ‘safe shoes’ quiz which has photographs of the shoes and asks people to rate them for safety. That’s also proving very popular, both in the wards and in the community.”
The symposium also provided an opportunity to showcase MidCentral’s Falls Aware Ward programme. The programme, which is in progress across Palmerston North Hospital, is now being rolled out to aged residential care – with great results. “All the aged residential care facilities in the district have signed up to take part!” says Jan.
The programme involves a pre-audit of the environment, considering things such as whether the call bell is placed near the patient, if the area is clutter-free, safe footwear and the inclusion of falls prevention in the patient’s care plan. Further audits are undertaken over time to measure how much compliance with best practice has increased.
And the early signs from all this work are positive.
Jan Dewar says over past months there has been a reduction in fractured hips at Palmerston North Hospital – with one since July 2014 compared with five for the same time the previous year.
“It is too early to tell whether this is a trend or what the reduction is linked to, but it is very encouraging for staff.”
Other April Falls activities included information in local media about how safe shoes can help prevent falls; Stand Up to Falls displays in hospitals, general practices and aged residential facilities, a safe shoe shopping guide developed with ACC; and promotion of the Health Quality & Safety Commission’s April Falls quiz.
The DHB is also working with St John’s Ambulance, on a project involving patients who have fallen but not needed to be taken to hospital. The focus of this work is to ensure patients are linked to their general practice team for assessment and implementation of falls prevention strategies.
“The approach to falls in the MidCentral region is a real community effort,’ says Jan. “By having everyone involved, we get a whole range of expertise and perspectives, and have built a fantastic network of health professionals to support our older people to stay safe.”