Implementation of a Falls Prevention Programme in Older Adult Residential CareMelissa Currid, Director of Nursing andA/Falls Prevention CoordinatorOlder Peoples Service, Donegal PCCC.

Older Peoples Service Donegal

“ Up here we’re different”

Statistics

Donegal has 21,471 Older people census (2011) – 13.3% of the population compared with 11.7% nationally.

Higher proportions of the oldest old – 5.8%, nationally = 5%

Difficulty accessing services / large rural areas.

Poor infrastructure, roads, transport.

11 Community Hospitals 162 long stay beds 226 Short stay beds 10 Day Hospitals 24 Day Centres 10 Directors of Nursing 508.9 WTE staff of all grades.

Each CH recording slips, trips and falls on monthly basis.

Each CH doing something different. Need Identified by DONS for a

structured falls prevention programme 2013 M C nominated by SMOPs as

OPS representative on Donegal PCCC falls committee.

While focus at meetings was primary care, need for residential/ inpatient programme was identified due to large number of Community Hospitals in the county.

Added as Service Plan priority for OPS, 2015

M C made contact with ANP Daragh Rodger in St Mary’s early October 2014.

Went to St Mary’s, spent a day gathering information and observing Forever Autumn in practice.

Brought back to Donegal and presented findings to SMOPS and DONS

Permission given by ANP Daragh Rodgers to use Forever Autumn programme.

Approval granted by SMOPS Donegal to proceed and purchase alert symbols, colour coded grips etc.

Why Forever Autumn?

Evidence from St Mary’s that it works! Simple concept - alert symbols, dignified

and non labelling, colour coded leaves, grips

Documentation user friendly and effective, comfort checks, post fall review.

Permission to use educational video Cost effective!

Progress to date in Donegal

Falls link/champion training took place in Nov 2014, 2 staff from each unit were trained.

Forever Autumn symbols, grips etc sourced. Education sessions commenced in January

2015 in each unit aimed at all grades of staff using the St Mary’s video.

All of the 11 Community Hospitals using the Forever Autumn leaf symbols and amended Falls Risk Assessment Tool (FRASE)

Falls Prevention Link Staff training Nov 2014, CNME, Letterkenny, Co Donegal.

A Falls Prevention Policy was developed for OPS, Donegal incorporating Forever Autumn and has now been implemented in each Community Hospital

The role of each grade of staff is clearly defined in the policy.

New documentation was introduced - Amended FRASE. - Comfort check. - Post Fall review. Falls pathway /algorithm poster for all units

Meetings are being held with all Falls Link staff at the end of each quarter to gain feedback and monitor progress.

Aim for all staff to be educated and Forever Autumn to be fully implemented in

all 11 Community Hospitals by 31st December 2015.

Aim for 30% reduction in falls across all Community Hospitals by 31st December 2015

Challenges

Introduction of additional documentation always met with some challenges – time!

FRASE – accuracy/validity questionable, ? Over predict risk.

Sourcing of colour coded grips!

Results so far….a quick glance 302 Staff of all grades educated

locally by falls link staff and falls prevention lead who has been visiting each location since June ‘15 providing support to all staff and falls links as well as delivering onsite education.

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10 11

Community Hospital

No.

of F

alls 2014

2015 YTD

Bottom line……....

2015 YTD( Jan – Jul ) evidence of 27.5% reduction in falls across all 11 Community Hospitals in Donegal!!

Going Forward…

Continue data collection Continue education of all grades of staff with a view to

granting same mandatory status. Standardised falls prevention equipment across all

sites. Review policy in 2016 with view to introducing FRAT

instead of FRASE. Gather data on interventions. Day hospitals / Day centres – falls prevention

awareness education and establish falls assessment clinics.

Share learning with other services PCCC, DL.

Thank you