5 Jul 2017 | Reducing Harm from Falls
A leading Australian falls prevention expert says health professionals need to continue to work hard to ensure falls do not drop off their radar.
The Health Quality & Safety Commission held four presentations in April with Dr Anne-Marie Hill.
Dr Hill is a full-time research academic in the School of Physiotherapy and Exercise Science at Curtin University.
She says a common theme she continues to see in the health sector is a lack of education for front-line health professionals and patients at risk of a fall.
‘We’re astonished that when we went to the two large nursing providers we work with, we see inconsistent handover information and other things like that. The issue is all the people at the top level know falls were an issue, but our research showed their employees didn’t know it was an issue. If people don’t think something’s an issue, how can they work to resolve it and educate,’ she says.
‘What I’m realising with time in the area is there are places that have corporate history, but then those people leave and new staff come in without the same knowledge, and this is how these things may fall off.’
Dr Hill says in her research surveying patients it is usual for them to rate their risk of a fall as ‘extremely unlikely’ and that they often say aren’t interested in falls prevention education as they haven’t been educated on falls risks.
‘We’ve taken this back to our physios to teach them that if you say nothing to a patient about falls risks, they assume you have told them everything they need to be aware of. If the physio doesn’t say ‘are you aware these exercises will help you’ the patients won’t do them and that makes it difficult to get the message across.’
‘[Another example is] patients will be given a frame to walk with, and when they are asked, they will say they use it all the time when they walk. But then we’ll ask if they use it when they to go to the toilet, they’ll say ‘I don’t use it for that’ because they don’t see that as ‘walking’. They don’t realise this is a risk for them and they think they’ve been following the instructions because they were told to use it when they walk.’
Dr Hill’s project on patient education in hospital showed a gradual reduction in falls in hospital, what we found was a direct correlation between cognition and outcomes.
‘We gave the education to everyone, even people with dementia, because our thought was if you could teach someone with dementia to ring the bell that is a positive. But there wasn’t that reduction in falls, they weren’t able to take on that message. So that was a valueable learning.’
But Dr Hill says while the focus of clinicians may be on avoiding adverse events in hospital, that doesn’t mean the problem is being solved.
‘I feel that as we are reducing the number of falls in hospital, we are now sending those falls home. We are reducing our length of stay in hospital and I believe what we’re starting to do is send our falls and our pressure and our medication adverse events into the community. They then have to come back to hospital as a readmission. We’re getting people that have had a fall going home, but nobody tells their GP that. The message gets lost when they go home and we need to work to make sure it doesn’t.’