NSW Falls Prevention Program - Making prevention everybody’s business
There is no other cause of injury which costs the health system more than falls.
In NSW in 2011-2012 there were 47,626 fall-related hospitalisations in people aged 65 years and over, and the rate is increasing at 3.8% per year. Fall related injuries comprised 31,902 (17,672 fractures and 14,223 non-fractures). Of particular concern is the rapid increase in rate of hospitalisations for traumatic brain injury (8.6% per year).
Projections indicate that unless preventative measures are taken, the demand on health care will escalate due to the rapidly ageing NSW population. No other single injury, including road trauma, collectively costs the health system more than fall injuries.
The NSW whole of government Ageing Strategy released in 2012 recognises as a priority action the need to maintain and improve efforts to reduce avoidable falls by older people in all settings. This includes promoting physical activity in recognition that regular exercise is one strategy for lowering the risk of falls.
“The care of an older person in hospital is complex and developing new approaches to care is required, especially for older frailer patients who are confused and may have dementia, as these are the patients that are most likely to fall.” LORRAINE LOVITT.
The NSW Falls Prevention Program provides statewide leadership, co-ordination and collaboration to implement falls evidence-based practice. The NSW Falls Policy Advisory Group provides strategic leadership and integration across a range of relevant health program initiatives that includes the Clinical Excellence Commission, the Agency for Clinical Innovation (ACI), the Ministry of Health (MoH) and Ambulance NSW. The NSW Local Heath District (LHD) Falls Co-ordinator collaborative supports standardised approaches for the implementation of LHD falls plans.
The NSW Health Policy for Prevention of Falls and Harm from Falls among Older People: 2011-2015 (PD2011_029) (‘the Policy’) was released in May 2011. The Policy aims to reduce the incidence and severity of falls among older people and reduce the social, psychological and economic impact of falls on individuals, families and the community. It addresses three key domains: health promotion, NSW Health clinical services (including hospital and community- based services) and NSW Health residential aged care services (multi-purpose services and State Government Residential Aged Care Facilities).
There is evidence that many falls among older people can be prevented, even in frailer older people and the evidence base for falls prevention has continued to grow.
The NSW Falls Prevention Network is a key partner that provides support through professional development, advocacy and communication. Forums and workshops are conducted across the state to support the dissemination of falls best-practice and initiatives. http://fallsnetwork.neura.edu.au
With respect to NSW Health clinical services and NSW Health residential aged care services, the Policy focuses on activities to support these services implement the Australian Commission for Safety and Quality in Health Care (ACSQHC) national best practice guidelines for preventing falls and harm from falls in older people. There are two related but distinct issues to be addressed in hospital settings - firstly, reducing falls that occur during hospital stays (often related to transient states such as acute illness), and secondly, reducing falls in the community by identifying older people at high risk of falls and providing assessment and intervention to manage their falls risk factors.
The recent introduction of the ACSQHC National Safety and Quality Health Service Standards (NSQHSS): Standard 10 Preventing Falls and Harm from Falls has become a priority for the program.
Leader of the NSW Falls prevention Program, CEC, Lorraine Lovitt says that they have developed a suite of resources to support LHDs across the state with the implementation of the National Standard. http://www.cec.health.nsw.gov.au/programs/falls-prevention/falls-resources
“The introduction of this standard has led to a more standardised approach to managing people at risk when they enter hospital and to improve communication with patients, families and carers about the sorts of interventions that may be put in place to keep them safe.
“There are ongoing challenges to support staff to improve falls risk screening, assessment and intervention but further work is underway with the development of eLearning Falls Modules for staff, and the provision of ongoing education.
In regards to the population health focus the Policy focuses on initiatives to promote uptake of exercise for falls prevention, provision of information to older people on reducing falls risk, and healthy ageing.
The NSW Active and Healthy website:
www.activeandhealthy.nsw.gov.au has been developed to provide the general community, health professionals and community service providers with information about falls prevention exercise programs available in local suburbs, as well as access to resources that highlight practical steps that people can take to stay active and on their feet.
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