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SA Health PowerPoint Template - Green - Falls Prevention in SA

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FALLS PREVENTION AND<br />

MANUAL HANDLING<br />

What’s the l<strong>in</strong>k?<br />

Pam Dean<br />

BAppScOT, MHlthSc(OT)<br />

Tra<strong>in</strong>er<br />

<strong>Prevention</strong> of <strong>Falls</strong> and<br />

Harm from <strong>Falls</strong><br />

Safety & Quality Unit<br />

<strong>SA</strong> <strong>Health</strong>


National evidence based Guidel<strong>in</strong>es<br />

Prevent<strong>in</strong>g <strong>Falls</strong> and Harm From<br />

<strong>Falls</strong> <strong>in</strong> older people<br />

http://www.safetyandquality.gov.au/<strong>in</strong>ternet/s<br />

afety/publish<strong>in</strong>g.nsf/Content/<strong>Falls</strong>Guidel<strong>in</strong>es<br />

ACUTE AGED CARE COMMUNITY


Subacute<br />

250<br />

200<br />

150<br />

100<br />

No. falls<br />

Injury Incidents<br />

50<br />

0<br />

1998/99 2000/01 2002/03 2004/05<br />

Courtesy St.Margaret’s Rehabilitation Hospital, Adelaide <strong>SA</strong>


Different Frames of Reference<br />

Risk<br />

management<br />

<strong>Prevention</strong><br />

Manual Handl<strong>in</strong>g<br />

Red Dot<br />

Prevent<strong>in</strong>g falls and harm from falls


Occupational<br />

<strong>Health</strong> & Safety<br />

concerned<br />

primarily with<br />

L<strong>in</strong>kage between Red Dot and <strong>Green</strong> Box<br />

<strong>Falls</strong> prevention<br />

approaches<br />

concerned with<br />

STAFF<br />

Individual risk<br />

factors<br />

Age, general<br />

health & fitness,<br />

<strong>in</strong>jury, fatigue,<br />

tra<strong>in</strong><strong>in</strong>g, etc<br />

INTERACTION RISKS<br />

SYSTEMS, EQUIPMENT<br />

& PRACTICES OF CARE<br />

Problems with unsafe systems,<br />

equipment & staff availability<br />

ENVIRONMENT<br />

Problems with slipp<strong>in</strong>g, tripp<strong>in</strong>g,<br />

light<strong>in</strong>g, steps or mov<strong>in</strong>g hazards<br />

PATIENT<br />

Individual risk<br />

factors<br />

Problems with<br />

balance, gait,<br />

medications,<br />

cont<strong>in</strong>ence,<br />

vision, feet, etc<br />

Red Dot<br />

- System to identify<br />

manual handl<strong>in</strong>g needs<br />

for mov<strong>in</strong>g patients<br />

-reduc<strong>in</strong>g<br />

staff <strong>in</strong>jury<br />

Acknowledgement: Michele<br />

Sutherland & Kirsten Mitchell<br />

Risk assessment<br />

and care plan<br />

<strong>Green</strong> box<br />

– resources for implement<strong>in</strong>g<br />

National Guidel<strong>in</strong>es<br />

-Reduc<strong>in</strong>g falls & harm from<br />

falls to patients <strong>in</strong> hospital<br />

& residential care<br />

31


RED DOT SYSTEM<br />

Independent<br />

Light assistance of 1 person<br />

Assistance from 2 people<br />

Non-weight bear<strong>in</strong>g<br />

Acknowledgement: Mann<strong>in</strong>g Base Hospital, NSW


<strong>Falls</strong> <strong>Prevention</strong> system<br />

Intr<strong>in</strong>sic Risk Factors<br />

Age – advanced age 75+ years and 55+ years of ATSI<br />

History of falls – predictive of more falls<br />

Conditions affect<strong>in</strong>g behaviour, mental state, judgement<br />

or <strong>in</strong>sight – sometimes modifiable<br />

Conditions affect ability to transfer and mobilise safely<br />

Medications affect<strong>in</strong>g reaction time, motor function,<br />

cause dizz<strong>in</strong>ess, postural drops <strong>in</strong> BP or Drows<strong>in</strong>ess.<br />

Polypharmacy.<br />

Risk factors for <strong>in</strong>jury or harm should a fall occur:<br />

•Poor bone strength; osteoporosis<br />

•Frail sk<strong>in</strong><br />

•Low BMI<br />

•Anticoagulant therapy or bleed<strong>in</strong>g disorder


Occupational<br />

<strong>Health</strong> & Safety<br />

concerned<br />

primarily with<br />

L<strong>in</strong>kage between Red Dot and <strong>Green</strong> Box<br />

<strong>Falls</strong> prevention<br />

approaches<br />

concerned with<br />

STAFF<br />

Individual risk<br />

factors<br />

Age, general<br />

health & fitness,<br />

<strong>in</strong>jury, fatigue,<br />

tra<strong>in</strong><strong>in</strong>g, etc<br />

INTERACTION RISKS<br />

SYSTEMS, EQUIPMENT<br />

& PRACTICES OF CARE<br />

Problems with unsafe systems,<br />

equipment & staff availability<br />

ENVIRONMENT<br />

Problems with slipp<strong>in</strong>g, tripp<strong>in</strong>g,<br />

light<strong>in</strong>g, steps or mov<strong>in</strong>g hazards<br />

PATIENT<br />

Individual risk<br />

factors<br />

Problems with<br />

balance, gait,<br />

medications,<br />

cont<strong>in</strong>ence,<br />

vision, feet, etc<br />

Red Dot<br />

- System to identify<br />

manual handl<strong>in</strong>g needs<br />

for mov<strong>in</strong>g patients<br />

-reduc<strong>in</strong>g<br />

staff <strong>in</strong>jury<br />

Acknowledgement: Michele<br />

Sutherland & Kirsten Mitchell<br />

Risk assessment<br />

and care plan<br />

<strong>Green</strong> box<br />

– resources for implement<strong>in</strong>g<br />

National Guidel<strong>in</strong>es<br />

-Reduc<strong>in</strong>g falls & harm from<br />

falls to patients <strong>in</strong> hospital<br />

& residential care<br />

31


Systems, equipment and practices of care:<br />

Manual handl<strong>in</strong>g<br />

<strong>Falls</strong> prevention<br />

Systems: no or m<strong>in</strong>imal lift;<br />

red dot<br />

Frame of reference:<br />

risk management<br />

Equipment: lifters, etc. to<br />

reduce stra<strong>in</strong> on workers.<br />

(Staff focused).<br />

Restra<strong>in</strong>t physical /<br />

chemical<br />

Systems: National<br />

guidel<strong>in</strong>es – risk<br />

identification and<br />

reduction of risk<br />

Frame of reference:<br />

<strong>Prevention</strong><br />

Equipment: to promote<br />

<strong>in</strong>dependence and<br />

function<br />

(older person focused)


Systems, equipment and practices of care:<br />

Care Practice:<br />

Care Practice:<br />

>Task oriented<br />

>Systems and practices to<br />

benefit staff<br />

>Level of risk identified<br />

> “Standard” falls prevention<br />

strategies<br />

> Identify risk factors<br />

> M<strong>in</strong>imise bed rest<br />

> Promote <strong>in</strong>dependence<br />

and activity<br />

> Involve and <strong>in</strong>form older<br />

person and family


Environment<br />

Manual handl<strong>in</strong>g focus<br />

<strong>Falls</strong> prevention focus<br />

> Rout<strong>in</strong>e OHS&W audits<br />

> OHS&W audits +<br />

> Assessment of<br />

<strong>in</strong>dividual hazards<br />

result<strong>in</strong>g from identified<br />

<strong>in</strong>tr<strong>in</strong>sic risk factors<br />

<strong>in</strong>teract<strong>in</strong>g with the<br />

environment


Risk Assessment and Care plan<br />

Strategies to<br />

manage identified<br />

level of falls risk:<br />

><strong>in</strong>crease monitor<strong>in</strong>g<br />

and surveillance –<br />

dependent on staff<br />

availability<br />

>provide assistance<br />

>reduce physical activity<br />

e.g restra<strong>in</strong>t;<br />

> Multifactorial and<br />

multidiscipl<strong>in</strong>ary<br />

strategies to<br />

reduce identified<br />

risk factors


Red Dot says<br />

“I will do my best to keep you safe,<br />

because you are at risk of falls”<br />

– dependent of nurs<strong>in</strong>g staff<br />

<strong>Falls</strong> <strong>Prevention</strong> says<br />

“I will work out why you are at risk of<br />

fall<strong>in</strong>g, and take action to reduce those<br />

risk factors”<br />

– uses multifactorial and<br />

multidiscipilnary <strong>in</strong>terventions


Good falls prevention<br />

complements safe manual<br />

handl<strong>in</strong>g practice and m<strong>in</strong>imal<br />

lift pr<strong>in</strong>ciples<br />

> Older people are safer and<br />

more <strong>in</strong>dependent<br />

> Staff <strong>in</strong>juries are decreased<br />

and there is less need for<br />

manual handl<strong>in</strong>g<br />

> <strong>Falls</strong> risk <strong>in</strong> managed and<br />

reduced<br />

= Improved safety and quality<br />

of life for older people and<br />

staff WIN, WIN!

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