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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 l.jpg
FALLS PREVENTION

  • Greater Glasgow and Clyde falls prevention service


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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


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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)


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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)


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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


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COMMON TRENDS IN FALLS

Not witnessed

Between bed/chair, toilet

Fulfilling basic physical needs

Morning and early evening

Less falls occur at meal times


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IMPLICATIONS OF A FALL

Personal impact to patient

Prolonged hospitalisation

Mortality and morbidity

Potential litigation


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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


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HOW WILL THIS SERVICE BE DELIVERED? RECOMMENDATIONS:

  • 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




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MULTIDISCIPLINARY INTERVENTIONS RECOMMENDATIONS:

  • Medical assessment

  • Pharmacy review

  • Nursing assessment

  • Physiotherapy assessment

  • Occupational Therapy assessment


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REFFERAL CRITERIA FOR THE HOSPITAL FALLS PREVENTION SERVICE RECOMMENDATIONS:

  • 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


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EQUIPMENT AVAILABLE RECOMMENDATIONS:

  • Hi-low beds

  • Enterprise 5000 beds

  • Bed monitors

  • Chair monitors

  • Adjustable height seating

  • Specialist seating

  • Non slip mats / one way glides


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SPIRIT ULTRA LOW BED RECOMMENDATIONS:


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BEDRAILS - INJURIES AND ENTRAPMENT RECOMMENDATIONS:

  • Rational for use / Bedrails risk assessment

  • Regular review of decision making

  • Are all bedrails in use fit for purpose?


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CAN INTERVENTIONS MAKE A DIFFERENCE? RECOMMENDATIONS:

  • 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 )


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REVIEW RECOMMENDATIONS:

  • REASSESS, DOCUMENT AND COMMUNICATE TO ALL STAFF IF PATIENTS CONDITION CHANGES OR IF THEY HAVE A FALL