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FALLS PREVENTION. Greater Glasgow and Clyde falls prevention service. OBJECTIVES. Raise awareness of falls problem Increase knowledge of Falls Services in Greater Glasgow and Clyde Explain role of Hospital Falls Prevention Service GG and Clyde Falls Management Guidelines and Policies
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FALLS PREVENTION • Greater Glasgow and Clyde falls prevention service
OBJECTIVES Raise awareness of falls problem Increase knowledge of Falls Services in Greater Glasgow and Clyde Explain role of Hospital Falls Prevention Service GG and Clyde Falls Management Guidelines and Policies Explain role of MDT in falls prevention
DEFINITION OF A FALL “A sudden unintentional change in position, causing one to land on a lower level, an object, the floor or ground.” Tinetti (1987)
GLASGOW HOSPITAL FALLS FACTS • 8,245 falls in Glasgow city hospitals • 766 head injuries sustained as result of a fall • 601 patients in South Glasgow fell out of bed • 118 patients sustained a fracture due to a fall • 43 patients injured as a result of bedrail entrapment Falls are the most commonly reported critical incident and a major source of morbidity and complaint Figures NHSGG H&S Dept (2006)
WHY FALLS OCCUR Medical condition Medication - polypharmacy Previous fall – loss of confidence Muscle weakness Gait and balance disturbances Confusion / Poor safety awareness Incontinence Visual/hearing impairment Footwear Environmental hazards
COMMON TRENDS IN FALLS Not witnessed Between bed/chair, toilet Fulfilling basic physical needs Morning and early evening Less falls occur at meal times
IMPLICATIONS OF A FALL Personal impact to patient Prolonged hospitalisation Mortality and morbidity Potential litigation
NHSGG OSTEOPOROSIS AND FALLS PREVENTION STRATEGY 2005-2010 RECOMMENDATIONS: All NHS GG&C patients to have a falls risk assessment & care plan To establish Hospital Falls Prevention Service • 5Hospital Falls Prevention Coordinators • 3 Care Homes Falls prevention Coordinators • £ 30,000 Falls Prevention aids and equipment Community Falls Prevention Programme • Physiotherapists • Occupational therapists • Support workers
HOW WILL THIS SERVICE BE DELIVERED? • One coordinator attached to each of the Glasgow Hospital areas • The Coordinator will support the dissemination of the Falls Management Guidelines and Policies • Supporting the introduction of Risk assessments / care plans for all patients • Providing education and training in Falls Management for all staff • Review incidence of patient falls and associated injuries in partnership with other services i.e. H&S, Risk Management • Local audits
MULTIDISCIPLINARY INTERVENTIONS • Medical assessment • Pharmacy review • Nursing assessment • Physiotherapy assessment • Occupational Therapy assessment
REFFERAL CRITERIA FOR THE HOSPITAL FALLS PREVENTION SERVICE • Cannard 18+ • 2nd or subsequent fall • Any fall with a significant injury for example:A fracture or significant bruising or laceration to head or body
EQUIPMENT AVAILABLE • Hi-low beds • Enterprise 5000 beds • Bed monitors • Chair monitors • Adjustable height seating • Specialist seating • Non slip mats / one way glides
BEDRAILS - INJURIES AND ENTRAPMENT • Rational for use / Bedrails risk assessment • Regular review of decision making • Are all bedrails in use fit for purpose?
CAN INTERVENTIONS MAKE A DIFFERENCE? • Using a targeted multiple intervention programme has been shown to reduce falls numbers by up to 30% and serious injuries by 28% ( Haines et al, 2004 )
REVIEW • REASSESS, DOCUMENT AND COMMUNICATE TO ALL STAFF IF PATIENTS CONDITION CHANGES OR IF THEY HAVE A FALL