Taking Positive Steps Falls Prevention Project Sue Gray Alison Wells

The impact of a fracture... The Department of Health) states that the cost of treating a fractured neck of femur in hospital is £12,000, this may vary depending on the length of stay which can be affected by complications such as pneumonia and pressure ulcers. One-third of those patients admitted from a residential home to hospital with a fractured neck of femur are discharged to a nursing home NICE (2011). The average price of care in the West Midlands for 2011/12 is £470 per week for a residential home and £700 for a nursing home. (Laing & Buisson 2011)

One-fifth of those residents that are discharged from hospital with a fractured neck of femur are readmitted to hospital within 3 months. Mortality is high – about 10% of people with a hip fracture die within 1 month and about one third within 12 months. A fractured hip will also have an impact on quality of life, during the first 12 months after a hip fracture over half of people who walked unaided prior to the fracture will be unable to walk independently and a third will experience difficulty sleeping due to pain (Osnes EK, Lofthus CM et al 2004)

Project details Aim To use a partnership approach to provide training about falls and Fracture Prevention for staff in Care Homes.

Objectives To develop and deliver a range of training methods and materials suitable to all staff and their working environments, including workbooks, eLearning, DVD material and face to face training To develop a portfolio of education that will be accessible to all grades and levels of staff, ranging from direct care to those with responsibility for writing and implementing strategies To develop training that is suitable for both Health and Non Health Professionals, Managers and ancillary staff

Approach Culture – Focusing on no (or appropriate) blame – Promoting openness and candour – Root Cause Analysis Holistic – Not just falls but looking at the resident as an individual

Homes invited to participate Nursing Homes23 Residential Homes28 (one home closed during the summer leaving 27 homes)

Number of participating homes Number of Homes Number of beds Nursing18815 Residential10348 Total281163

Types of training delivered Managers Workshops Train the Trainer In House Training Sessions (half day) Root Cause Analysis Workshops Workbooks Sessions for domestics/housekeepers Session delivered to CQC inspectors

Number of people we have trained Session Managers40 Train the Trainer64 Half Day sessions200 Root Cause Analysis20 CQC Inspectors12 Domestics10 Total346

Data Collection Birmingham City Council West Midlands Ambulance Service University Hospitals Birmingham NHS Foundation Trust and The National Hip Fracture Data Base Nursing and Residential Homes involved in the project Questionnaires from training sessions Evaluations from training sessions

Some comments... The materials and handouts uses in the presentation and the lectures were informative and clearly explained The trainers made it interesting and not boring, they did an excellent training session It was good training, educative and informative It was very interesting, I learnt a great deal I have learnt that there are ways to help and reduce falls in the care home, also how to record them.

I am now more aware now of reasons why falls risks are so high and now have more knowledge of how to prevent and reduce the risk I can now develop a programme of education relating to falls and fractures prevention for nursing homes Trainers were interesting to listen to, anecdotes and additional information to the slides made for captivating learning’

Issues Encouraging all homes to participate Communication with homes Trainers Training