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Five Hills Health Region
Falls Prevention in Home Care
Apr 21, 2023 Saskatchewan Falls Collaborative 2
BackgroundSite:
•Moose Jaw Union Hospital
Team:
•Home Care and Community Therapies
Patient Population:
•Home Health Service Clients, Team 1 and 2
Rationale:
•These clients receive more long term service that typically involves personal care support
•Higher needs client base, higher risk for falls
Apr 21, 2023 Saskatchewan Falls Collaborative 3
AimPurpose:•To decrease falls by 20% or more by March 2010
Goals/Objectives
•To have 100% of falls reported to Client Service Managers
•To establish a process to identify at risk clients
•To ensure that all at risk clients have falls prevention intervention
Boundaries:
•Exclude Team 3 home services clients
Aim
• Challenges:
- Identifying that falls have occurred
- Documenting/tracking of falls reports
- Communicating falls between disciplines
- Implementing timely falls interventions
Apr 21, 2023 Saskatchewan Falls Collaborative 4
Apr 21, 2023 Saskatchewan Falls Collaborative 5
Team Members• Home Care
- Pauline Osemlak, DNS (Team Leader)
- Tracey Macfarlane, RN
- Corrie Hordick, HHA
- Jennifer Erbach, HHA.
• Community Therapies
- Lisa Benson, PT
- Dana Philipation, PT
• Team Sponsor
- Bert Linklater, EDCC
Apr 21, 2023 Saskatchewan Falls Collaborative 6
Results1. BERG Score Analysis
From the analysis (wilcoxon & sign tests) there is a significant difference between initial scores and FU scores.
Results2. Falls rate per 1000 (%)
Apr 21, 2023 Saskatchewan Falls Collaborative 7
Results3. Percentage of falls causing injury (%)
Apr 21, 2023 Saskatchewan Falls Collaborative 8
Apr 21, 2023 Saskatchewan Falls Collaborative 9
Changes Tested1. Cards clipped to name tags:
Ask these 3 questions before you leave a client’s home:•Have you had a slip, trip or fall since I last saw you?
•Do you have your lifeline or phone with you?
•Do you need anything before I leave
(above on the front, below on the back)
•Prevent Falls: Keep your clients safe in their homes!
•Asking these simple questions will reduce risk of falls and injury due to falls.
•Look for environmental hazards and encourage clients to reduce these hazards.
•Remember to report all falls to your supervisor.
2. Falls Records Doc Book and tracking by Client Services Managers
DATEOF FALL
TIME OF FALL
LOCATIONOF FALL
INJURY CODE1,2,3,4 SEE
BELOW DESCRIPTION OF EVENT
REPORT TO SUPERVISOR
DATE,TIMEINITIAL ACTION/TEACHING
Definition of Fall An event that results in a person coming to rest inadvertently on the ground or floor or lower level, with or without injury. INJURY CODE: Code 1 - No injury. Code 2 - Minor Injury. Requires basic first aid or short term monitoring. (e.g. skin tear, bruise) Code 3 - Adverse outcome. Major injury. (eg. Fracture, head trauma, ER assessment, admission to hospital.) Code 4 - Tragic incident. Death.
HAVE YOU HAD A SLIP, TRIP OR FALL?
NAME:FALL RECORDHSN:
CLIENT NAME DATE OF FALL LOCATION OF FALL INJURY CODE
19-Sep-11 Home 1
16-Sep-11 Home 1
04-Oct-11 Daughter's home 1
07-Oct-11 Home 2
Oct 6 & 7, 2011 Home 2
12-Oct-11 Home; fell out of bed (side rail in place) 2
06-Oct-11 Slipped in shower; didn't completely fall 1
20-Oct-11 In home 2
07-Sep 1
01-Sep fell in living room 1
Oct 8-11 at families in Saskatoon-fell a few times 2
30-Oct at home-visit to emerg 2
29-Oct-11 home 1
Oct. 30, 2011 bedroom 2
25-Oct-11 getting into medi chair 1
01-Nov-11 getting out of bed, slipped on rug 1
01-Nov fell in bathroom-Bentley staff helped her up 1
07-Nov fell in bathroom-Bentley staff helped her up 1
Nov. 7 fell in livingroom, missed chair 1
07-Nov fell in apartment, HHA arrived and sent by ambulance to hosp 2
Nov 8-fell 3-4 days ago fell in apartment. 1
31-Oct fell in apartment no injury 1
Nov. 16 apartment 2
Nov. 20 apartment 1
3. Community Therapies Falls Prevention Tracking
Client Name Initial Berg Score
Date # of PTA visits
F/U Berg Score Date Comments
4. Community Therapies Falls Prevention Algorithm
Apr 21, 2023 Saskatchewan Falls Collaborative 13
Five Hills Health Region
Community Therapy
Falls Prevention Program
5. Presentations:To Home Health Aids, Moose Jaw EMS,
ER department at MJUH
6. Moose Jaw EMS referral process
• Refer all clients with mobility impairments that you do not transport
• Referral process:– Write in instruction area
that info has been given to Therapies
– Ensure client signs form– Fax to Therapies
694-8710
Apr 21, 2023 Saskatchewan Falls Collaborative 16
Lessons Learned
• Communication is key
• Need a process to deal with volume of referrals/amount of falls
• Falls prevention requires ongoing support from many disciplines and agencies:
- Quality Improvement - Epidemiology
- Primary Health Care - Home Care
- Access Centre - Therapies
- Physicians - EMS/ER
Apr 21, 2023 Saskatchewan Falls Collaborative 17
Next Steps• Review data collection processes
• Formally track the volume of falls referrals to Therapies from all sources: ER, EMS, Home Care, Access Centre, inpatient wards, self/family, physicians.
• Connect with Primary Health Care and the Falls Steering Committee?
• Presentations to local physicians?
• How do we implement timely interventions with the same amount of staff?