Bolton Falls Service An Evidence Based Approach

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Bolton Falls ServiceAn Evidence Based Approach

• Sarah Rutherford Falls Co-ordinator

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Prior to the Falls Service What happened to
Boltons Fallers ?

• Many were not identified
• Referrals were sent to varying sources
• Therapists were very enthusiastic but treatment
  approach varied
• Some seen by one professional, some by more
• Duplicate assessments/ treatment
• Lack of communication between disciplines

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Plan for Development of Bolton Falls Service

• Dynamic Consultant pushing Falls agenda
• Existing Therapy Services audited
• Detailed Falls Assessment needed -Falls appear
  to result from complex interactions of multiple
  factors (Rowe 2000)
• Co-ordinated approach to fallers required -Multi
  faceted interventions reduce falls in older
  people (Feder, Cryer, Donovan Carter 2000)
• Care pathway needed for all fallers

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Gathering Analysing the Evidence

• Attendance at conference EBP to support multi
  disciplinary interventions to reduce the risk of
  falls.
• NHS Plan. - 2000
• NSF for older people standard 6.- 2001
• CSP/COT Audit Pack guidelines for the
  collaborative management of elderly people who
  have fallen.- 2001
• Results of audit on therapy services.
• All evidence shows MDT approach is the most
  effective.

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Bolton Falls Team What happens now !

• One stop referral point
• All referrals prioritised
• Multi disciplinary falls assessment tool
• Falls Clinic as appropriate
• Evidence based therapeutic intervention for 4
  main themes balance, confidence, environment,
  long lie, among other identified needs.

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Ongoing Evidence

• Practice in Bolton continues to develop with
  evidence
• Hip protectors - Parker, Gillespie Gillespie
  (2002)
• Proposed nice guidelines - First draft Jan 2004
• Visual acuity - The importance of vision in
  preventing falls (British Geriatric Society
  compendium document H1 2003)
• Multi factorial interventions (400 risk factors)
• Falls diaries
• Medication reviews e.g. psychotropic withdrawal
  - Pharmacists can play an important role in
  preventing falls in older people (Bellingham
  2001)

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Multi Agency Falls Group

• Age concern Accident prevention
• Leisure Moving more often
• Chair Based exercise programme
• Fall prevention programme day care /
  intermediate care settings
• MDT approach in hospital (orthopaedic and rehab
  wards in particular)
• Future involvement of Social Services etc