Falls Prevention & Management In Residential Care Setting  

Falls Prevention and Management in

Residential Care Settings: A

Research Study

Daragh Rodger

Advanced Nurse Practitioner

Care of the Older Adult Community

& PhD Student

6th September 2017

30% of over 75 year olds fell last year

1 in 5 reported a fall

1 in 10 reported an injurious fall

Prevalence increases with age

Significant impact on services and economy

Facts & Figures on Falls

Global ViewFact: 1:3 over 65 years & 1:2 over 80 years falls each year

Fact: 424 000 individuals die from falls globally each year

Fact: Adults older than 65 suffer the greatest number of fatal falls

Fact: 37.3 million falls require medical attention each year

Fact: Falls are one of the most common adverse event to occur in health care settings for older people

Fact: Older adults in residential care settings have a 3 times greater risk of falling compared to community dwelling older adults

Facts & Figures on Falls

Background to study

• Audit of falls in 2011 demonstrated the number of falls

and falls related injuries among older adults residential

service

• Higher incidence in residential setting due to disability

and frailty

• Ageing population - average age 86 years

• Many standard measures in place - what else can be

done to reduce falls risk?

• Forever Autumn Falls Prevention Programme developed

and implemented 2012

FOREVER AUTUMN……

….A falls prevention programme for all staff – clinical and non clinical, raising awareness of the potential for falls amongst older adults in residential care.

Elements included:

• Revision of Falls Prevention and Management Policy

• New Falls Risk Assessment Tool

• New Falls Risk Symbols

• New Falls Reduction Measures

Comfort checks & Post fall review

• Collection of new data

Phoenix Park Community Nursing Unit – Falls Data

*Compared to falls data pre Forever Autumn in 2011

Year Reduction in falls

2013 35%*

2014 33%*

2015 30%*

2016 31%*

How does Forever Autumn Falls Prevention Programme reduce the incidence of falls in residential care

setting?

Proposed research question

Research Process

Proposal Title: An evaluation of a falls prevention programme for adults living in residential care settings

Objective: To inform the future development of a falls incidence register for residential care settings in Ireland.

Ethics approval: Applied for in 2016 through DCU and permission obtained from each of the study sites to carry out the study

Research Sites: one urban Dublin & one rural Donegal

Criteria to participate: have implemented Forever Autumn Falls Prevention Programme for six months or longer

Research Methodology: Case Study Design

Research Method: Mixed Method

Why Case Study ?

- It provides the opportunity to investigate the uniqueness and complexity of the falls prevention programme.

- to explore multiple realities - different elements of the falls prevention programme within one case to gain a better understanding of the experience and which aims to support the generation of new knowledge to support future practice

Research Method

Mixed Method approach will be

taken.

It is envisaged the integration of the

findings from both qualitative and

quantitative data can provide value

and insight to the study.

This will in turn support the building of

knowledge to guide falls reduction

intervention programmes.

Research Method

Qualitative – Focus group interviews with staff who are familiar with and have experience of using the FA programme

A focus group typically consists of a small number of participants, usually around six to 12

The purpose of the focus group is to to draw on the participants experiences, beliefs and reactions in a way in which would not be feasible using other methods eg questionnaires, surveys

Research Method

OR= Over reaching; AS= Attempting to stand; GT= Going to the toilet; WWS= Walking without shoes; WWA= Walking without aid; LF= Leaning on furniture; UFA= Using furniture to ambulate; NN= Narrative note written

•What was the person doing? (Insert code in appropriate box)

Date

Time

Code

Initials

New Data Measurement Interventions to prevent potential falls

9262 in 2016Evidence to staff of benefits of ForeverAutumn Programme in action

Quantitative – Examine in depth the data from existing intervention records to

establish if they can provide any further information on prominent individual risk

factors

Next Steps

..To meet with research sites in late 2017

.. To provide presentation of proposed research and information on participant involvement to each site

..To commence data collection in early 2018

Thank you

[email protected]

www.bonehealth.co

[email protected]