Ms Daragh Rodger ANP Care of the Older Adult Community & PhD Student DCU

1. Falls Prevention
and Management in
Residential Care
Settings: A
Research Study
Daragh Rodger
Advanced Nurse Practitioner
Care of the Older Adult
Community
& PhD Student
6th September 2017

2. 30% of over 75 year olds fell last year
1 in 5 reported a fall
1 in 10 reported an injurious fall
Prevalence increases with age
Significant impact on services and
economy
Facts & Figures on Falls

3. Global ViewFact: 1:3 over 65 years & 1:2 over 80 years falls each
year
Fact: 424 000 individuals die from falls globally each year
Fact: Adults older than 65 suffer the greatest number of
fatal falls
Fact: 37.3 million falls require medical attention each year
Fact: Falls are one of the most common adverse event to
occur in health care settings for older people
Fact: Older adults in residential care settings have a 3
times greater risk of falling compared to community
dwelling older adults
Facts & Figures on Falls

4. Background to study
• Audit of falls in 2011 demonstrated the number of falls
and falls related injuries among older adults residential
service
• Higher incidence in residential setting due to disability
and frailty
• Ageing population - average age 86 years
• Many standard measures in place - what else can be
done to reduce falls risk?
• Forever Autumn Falls Prevention Programme developed
and implemented 2012

5. FOREVER AUTUMN……
….A falls prevention programme for all staff – clinical
and non clinical, raising awareness of the potential
for falls amongst older adults in residential care.
Elements included:
• Revision of Falls Prevention and Management
Policy
• New Falls Risk Assessment Tool
• New Falls Risk Symbols
• New Falls Reduction Measures
Comfort checks & Post fall review
• Collection of new data

6. Phoenix Park Community Nursing Unit – Falls Data
*Compared to falls data pre Forever Autumn in 2011
Year Reduction in falls
2013 35%*
2014 33%*
2015 30%*
2016 31%*

7. How does Forever Autumn Falls
Prevention Programme reduce the
incidence of falls in residential care
setting?
Proposed research question

8. Research Process
Proposal Title: An evaluation of a falls prevention
programme for adults living in residential care settings
Objective: To inform the future development of a falls
incidence register for residential care settings in Ireland.
Ethics approval: Applied for in 2016 through DCU and
permission obtained from each of the study sites to
carry out the study
Research Sites: one urban Dublin & one rural Donegal
Criteria to participate: have implemented Forever
Autumn Falls Prevention Programme for six months or
longer
Research Methodology: Case Study Design
Research Method: Mixed Method

9. Why Case Study ?
- It provides the opportunity to investigate
the uniqueness and complexity of the falls
prevention programme.
- to explore multiple realities - different
elements of the falls prevention
programme within one case to gain a
better understanding of the experience
and which aims to support the generation
of new knowledge to support future
practice

10. Research Method
Mixed Method approach will be
taken.
It is envisaged the integration of the
findings from both qualitative and
quantitative data can provide value
and insight to the study.
This will in turn support the building of
knowledge to guide falls reduction
intervention programmes.

11. Research Method
Qualitative – Focus group interviews with staff who
are familiar with and have experience of using the
FA programme
A focus group typically consists of a small number of
participants, usually around six to 12
The purpose of the focus group is to to draw on the
participants experiences, beliefs and reactions in a
way in which would not be feasible using other
methods eg questionnaires, surveys

12. Research Method
OR= Over reaching; AS= Attempting to stand; GT= Going to the toilet; WWS= Walking without shoes; WWA=
Walking without aid; LF= Leaning on furniture; UFA= Using furniture to ambulate; NN= Narrative note written
•What was the person doing? (Insert code in appropriate box)
Date
Time
Code
Initials
New Data Measurement
Interventions to prevent potential falls
9262 in 2016
Evidence to staff of benefits of Forever
Autumn Programme in action
Quantitative – Examine in depth the data from existing intervention records to
establish if they can provide any further information on prominent individual risk
factors

13. Next Steps
..To meet with research sites in late 2017
.. To provide presentation of proposed
research and information on participant
involvement to each site
..To commence data collection in early
2018

14. Thank you
daragh.rodger@hse.ie
www.bonehealth.co
daragh.rodger@hse.ie