1 morning llovitt nswfallsprogram -...
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HNEAHSMarch 2008
Lorraine Lovitt
NSW Falls Prevention Program
Fall injury in older people
• Falls are the most common cause of serious injury in older people, and the home is the most common place where falls occur
• Estimates that 1 in 3 people > 65 years in community will fall each year: 30% will require medical attention and 10% will have multiple falls
• Falls are the leading cause of injury in hospitals and hospital incidences related to falls. A serious fall frequently becomes the precipitating event into residential care
Fall injury in older people
In NSW in 2004-05: • 28, 178 people aged 65 years and over had a
fall that resulted in hospitalisations
• 8,888 males: 19,287 females, a rate of 2,962 per 100,000 (Population Health Division, 2007)
• cost of fall related injury is expected to rise dramaticallyover the next 50 years unless effective prevention and lower treatment costs occur
• In NSW with no effective measures in place an • additional 800 new hospital beds allocated to fall injury
treatment will be required • 1,200 nursing home places’*
*(Moller 2003), WHO, Global Report on Falls Prevention in Older Age August 2007
Fall injury in older peopleProjections
Projected bed day demand in New South Wales based on current risk and treatment patterns
National Falls PreventionFor Older People Plan:
2004 onwards
Department of Health and Ageing
To support a nationally consistent approach to effectively preventing falls
•National planning to review and progress policy
National Falls PreventionFor Older People Plan: 2004 onwards
Implementation Strategy short term strategy• Progressing the supplementation of residents of aged care
facilities with vitamin D and calcium, as well as those aged 65 years and over with an identified vitamin D deficiency (WA, SA & AUSTRALIAN GOVT)
• Promote implementation of the Australian Council for Safety and Quality in Health Care Falls Prevention Best Practice Guidelines within residential aged care facilities (including through relevant accreditation standards) (NSW CEC & WA)
Australian Council for Safety and Quality in Health Care
Best practice guidelines for Australian hospitals andresidential aged care
facilitiesSept 2005
Australian Commission S&Q www.safetyandquality.org
•Format revised for download 07•Process for updating evidence 08
National Falls PreventionFor Older People Plan: 2004 onwards
• Progressing the Development of a National Resource to inform Consistent Practice in Community Settings
(Qld, NSW, Victoria, NT ACT)
• Adoption of the Qld Community best-practice guidelines
• Develop a dissemination and implementation strategy
Flow for Falls Prevention
Health Promotion
Lead
Primary Prevention
O H & SEnvironmental
Hazard Management
Partnerships Strategies
Older people engage in physical
activity that includes
strength and balance
Community Awareness• Information • Education• ‘Good news’ media
Range of Potential Partners
Providers of Physical Activity•Tai Chi•Fitness Leaders•Fitness Gyms• CHEGS•Active> 50•Heart Moves
•CALD Communities eg Italian, Sikh, German, Sudanese, Arabic, Chinese
• Community Service providers e.g. flexi HACC• Community Participation Forum – Peer Education• Local Gov A’s
•community workers• council walking /exercise groups•senior Expos
•Disability services e.g. Vision Australia, Northcott• Disadvantaged communities• Aboriginal Medical Services
Public Services
Local Government
Multifactorial FallsRisk Assessment and Management and/or Referral
•Falls and medical history•Medications•Strength, balance, mobility•Vision•Urinary incontinence•Nutrition•
Strength&
Balance Training
Group &/ or
in-home
monitoring
•Allied Health: Public/Private•Occ Therapist•Phys Therapist•Podiatry
•Community Nursing•Private Nursing Services•Day Therapy•Allied Health •ACAT•Transition Care•Pharmacist•GP’s — Divisions/Practice Nurses•Rehab Services (physio)•Exercise Physiologists
•Fitness service
•HACC•DVA•MPs•RACF•CACP & EACH•CRC•Carelink
Secondary PreventionMed- High Risk
Potential Partners
time limited
ED ASET
ED staff
•Screen•Register
Falls prevention assessment and plan of careInformation on physical activity& falls prevention
•Allied Health •Occ Therapist•Phys Therapist
•Community Nursing
•Private Nursing
•Day Therapy
•Allied Health
•ACAT
•Transition Care
•HACC
•DVA
•MPs
•RACF
•CACP & EACH
•CRC
•Carelink
•GP & GP Practice Nurses
Health Aged Care Services
ADMIT
NOT ADMIT
Range of other Community services
•Information on physical activity& falls prevention•Referral for assessment and follow-up
Referral Network
DischargeDischarge planners, (SW, OT, Dietitian, ) ComPacks, Ward Staff
Discharge
Management PolicyTo
Reduce Fall Injury in Older People
To reduce fall injury among older people in
NSW
•Review of evidence•Consultations 2008
NSW StateNSW State--widewide
Expert Advisory Groups
Manager, Injury Prevention Policy Branch
NSW Department of Health
NCAHSFalls Co &AFMC*
NSCCAHS Falls Co & AFMC*
HNEAH Falls Co & AFMC*
SESIAHS Falls Co & AFMC*
SSWAHSFalls Co & AFMC*
SWAHS Falls Co & AFMC*
GSAHS Falls Co &AF MC*
GWAHS Falls Co & AFMC*
Falls InjuryPrevention Network
Prince Of WalesMedical Research
Institute(Project Officer)
Injury Risk Management Research
Centre (IRMRC)University of NSW
(Monitoring and Evaluation)
Department of Health•Health System Performance –Quality & Safety•Inter-Government& Funding Strategies – Aged Care Integration •Asset & Contract Services
NSW Leader Falls Program
Clinical Excellence Commission
Acute Care
Implementation of “BIG GREEN BOX”• Development of supporting materials:
– best-practice tips and a trigger DVD • Rural Telehealth initiative (May- June 07) – DVD/CD
• IIMS reporting and monitoring
• Performance monitoring - CEs Performance agreement• Hospital falls: deaths and injury (Sac 1 and 2) • Population Health: fall-related admissions to hospital
Lorraine Lovitt
NSW Falls Prevention Injury Network
(Prince of Wales Medical Research Institute)
www.powmri.edu.au/fallsnetwork