This document provides information on falls prevention in Cambridgeshire, including:
1. Definitions of falls and data on falls rates among older residents. Over 2,450 residents age 65+ are injured from falls each year.
2. Risk factors for falls include age, medical conditions, mobility issues, and home hazards. The majority of falls occur at home.
3. Guidance from NICE recommends multifactorial risk assessments and interventions like exercise programs and home modifications to prevent falls.
4. Evidence shows group exercise, home safety programs, and multifactorial interventions can reduce fall rates. Programs focused on strength, balance and functional training are most effective.
Presented by: Angela Greetham, Bay of Plenty DHB
at OHSIG 2014, Thursday 11/9/14, Limelight Room 1, 11.15am
Video URLs:
HQSC on fall prevention: www.youtube.com/watch?v=NdO7JCXJBO4
Falls are Not Inevitable: Designing and Implementing a Comprehensive, Evidenc...Cora Butler, JD, RN, CHC
Learning Objectives:
1) Describe the individual and residential care setting consequences of falls in the senior population.
2) Identify best practices for developing a comprehensive multi-disciplinary approach to fall prevention and fall management.
3) Discuss the balance between maintaining resident safety and a resident’s right to self-determination (right to choose).
4) Identify the role and application of data driven approaches and emerging technologies in maintaining quality and resident safety in senior living settings.
5) Identify ways to sustain performance over time.
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
Bandaging and Splinting & Slings; Techniques and Types (Health Subject)Jewel Jem
A short report about bandaging, types of bandages, bandaging techniques and even Splinting & Slings, types of splinting & slings, splinting & Splints techniques
Presented by: Angela Greetham, Bay of Plenty DHB
at OHSIG 2014, Thursday 11/9/14, Limelight Room 1, 11.15am
Video URLs:
HQSC on fall prevention: www.youtube.com/watch?v=NdO7JCXJBO4
Falls are Not Inevitable: Designing and Implementing a Comprehensive, Evidenc...Cora Butler, JD, RN, CHC
Learning Objectives:
1) Describe the individual and residential care setting consequences of falls in the senior population.
2) Identify best practices for developing a comprehensive multi-disciplinary approach to fall prevention and fall management.
3) Discuss the balance between maintaining resident safety and a resident’s right to self-determination (right to choose).
4) Identify the role and application of data driven approaches and emerging technologies in maintaining quality and resident safety in senior living settings.
5) Identify ways to sustain performance over time.
I picked that presentation from the internet and edited it, all rights reserved to the original owner. Anyhow this presentation might be helpful for med students doing their emergency rotation/elective and especially those who don't have an instructor or any kind of mentor in their emergency elective, like me.
Bandaging and Splinting & Slings; Techniques and Types (Health Subject)Jewel Jem
A short report about bandaging, types of bandages, bandaging techniques and even Splinting & Slings, types of splinting & slings, splinting & Splints techniques
We held an improvement collaborative with 19 NHS providers earlier this year to help improve the management of falls in an inpatient setting.
This resource shows case studies of the providers involved in the collaborative.
Improving the Physical health care of people with mental ill health: Cardiovascular health of people with serious mental illness National Learning Network Event 29th April 2015.
Main Slide: NHS IQ CVD SMI LNE 29 April 2015 slides - 1-152
BREAKOUT 1_PATIENT VOICE slides 153-161
BREAKOUT 2a_IMPROVING CARDIOVASCULAR CARE FOR PEOPLE WITH SMI - slides 162-188
BREAKOUT 2b_UCLP PROGRAMME ON CVDSMI - slides 188-195
BREAKOUT 3_PHYSICAL ACTIVITY IN MENTAL HEALTH - slides 196-212
BREAKOUT 4_REASONS FOR TEWVS SUCCESS - slides 213-225
BREAKOUT 5_ PHYSICAL HEALTH AND WELLBEING - slides 226-243
BREAKOUT 6_SHAPE - slides 244-271
BREAKOUT 7_SCREENING FOR CARDIOMETABOLIC RISK FACTORS - slides 272 -296
Fall prevention for the Elderly Population | VITAS HealthcareVITAS Healthcare
The goal of this presentation is to learn the reasons for falls and to develop effective fall prevention strategies.
Objectives:
- Describe the incidence of falls in the elderly patient
- Define conditions contributing to falls
- Identify risk factors related to falls
- Explain and complete the basic fall assessment
- Describe the team approach to reduce falls
Welcome and the National Patient Safety Plan - Dr Mike Durkin (Chair), Director for Patient Safety, NHS England
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
Running head EPIDEMIOLOGICAL AND NEEDS ASSESSMENT .docxsusanschei
Running head: EPIDEMIOLOGICAL AND NEEDS ASSESSMENT 1
EPIDEMIOLOGICAL AND NEEDS ASSESSMENT 6
Epidemiological and Needs Assessment
Student’s name:
Course:
Tutor:
Date:
Epidemiological Assessment in Union County Georgia
Chronic diseases are the leading causes of morbidity and death in union County Georgia. Some of the chronic diseases that lead in death rates include heart disease, stroke, cancer, diabetes, and chronic respiratory diseases. Obesity is a serious health concern the increases the risk of other chronic diseases (CHRR, 2014). A good proportion of UCG’s population is obese with about 30% of adults 18 years and older being obese and about 12% of high school student aged between 14-18 years. Among the chronic diseases, cardiovascular disease was the leading cause of death accounting for about 35% of all deaths in Union County Georgia. Death rates resulting from cardiovascular disease were high among men than among women and higher for blacks than for whites (CHRR, 2014). Most of those who died from these diseases were also below the age of 65. Generally speaking of all the chronic diseases then females were likely to suffer more than one chronic disease than the males. Adults with public health insurance were also more likely to suffer one or more of the chronic diseases.
Most of the chronic diseases are caused by lifestyle people choose to live or by their preferred diets. Diet and eating habit are risk factors for most of these chronic diseases and therefore must be looked into. Taking obesity and stroke for instance, they are both caused by taking high fat foods and lack of physical exercise (OMMQT, 2014). High fat foods are usually cheap and readily available thus the habit of taking high fat foods often can be attributed to laziness or low socio economic status to afford the healthy food on a daily basis. Smoking lack of physical exercise, poor eating habits, obesity and diabetes are all risk factors for most of the chronic diseases which results in death and morbidity. Some of the cardiovascular diseases that often lead to hospitalization include heart disease, type II diabetes and stroke with heart disease being the reason for a majority of chronic diseases admissions.
Cancer is also a major cause of death in Union County Georgia and is among the chronic diseases. Cancer is caused by so many factors but still diet comes in among the many factors some of which include the genetics. Among the residents of Georgia there are about 100 new diagnosis of cancer reported daily with the exception of skin cancer and carcinoma. Prostate cancer among men and breast cancer in women are the leading types of cancer diagnosed in this community (UCB, 2014). Leukemia cases are the least heard of though they also exist among the residents here.
Health Needs As ...
This is the slide deck from the Masterclass for Prevention given on March 4th 2016 as part of the series of Public Health Masterclasses between the University of Hertfordshire and the County Council. It aims to articulate a "systematics" of prevention
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
Similar to Falls prevention slideset for training use - March 2016 (20)
Cambridgeshire atlases-Data visualisation of local socio-demographic dataCambridgeshireInsight
The Cambridgeshire Atlas is a display tool that allows users to view interactive atlases, dashboards, profiles or key indicator reports. It is easy to use and helps users to understand complicated socio-economic datasets quickly.
It combines maps, charts and graphs to allow viewing of data trends for different geographies in Cambridgeshire.
Cambridgeshire Atlases cover a number of themes including Census 2011, Deprivation, Community Safety, Housing, People and Population and Social Classification. See more at: http://cambridgeshireinsight.org.uk/interactive-maps
This is presentation outline the main local insights, data and intelligence produced by the Cambridge Sub Regional Housing Board. It includes web pages, data visualisations, open data and reports.
A study of ‘who are the victims of crime in Cambridgeshire & Peterborough now?’ Highlighting the shape and nature of victimisation in Cambridgeshire and Peterborough.
Policy Compass Workshop, 1st of June 2015
The main goal of Policy Compass is to develop a research prototype of an easy-to-use, highly visual and intuitive tool for social networks and eParticipation platforms, enabling citizens and public officials to easily create, apply, share, embed, annotate and discuss causal models, charts and graphs of historical data from trusted open data sources. The aim is to develop methods and tools that facilitate more factual, evidence-based, transparent and accountable policy evaluation and analysis.
http://policycompass.eu/
Greater Cambridge Greater Peterborough Economic Assessment Data Atlas IntroCambridgeshireInsight
The Greater Cambridge Greater Peterborough Economic Assessment provides a wealth of economic evidence for the Greater Cambridge Greater Peterborough Local Enterprise Partnership (GCGP LEP) area and its constituent districts.
The GCGP Economic Assessment is divided into three sections: People, Business and Place. The Assessment presents a variety of data from different sources. The main geographies used in this Atlas are districts and 2011 wards, although others are used where necessary. The Atlas sits alongside analysis of the evidence and the raw data (Excel spreadsheets).
More data will be available as further datasets are added to the Assessment over the coming months. All available data can be explored from the Data Index.
This slideshow provides tips on how to use the GCGP Economic Assessment Atlas.
Cambridgeshire County Council's Research Group are celebrating LARIA's Local Area Research Fortnight by hosting a series of lunchtime seminars on their work.
This is Seminar 2: Demography and Pupil Forecasting
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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NVBDCP.pptx Nation vector borne disease control program
Falls prevention slideset for training use - March 2016
1. Injurious falls in Cambridgeshire
Falls Prevention Slideset
March 2016
Public Health, Cambridgeshire County Council
2. Slideset Notes
• This slideset has been developed by Public Health at
Cambridgeshire County Council for use in training and
awareness raising activities for falls prevention
• Feel free to adapt and tailor appropriately for
particular events and audiences
• Please ensure technical notes and references related to
the quantitative data provided remain in place
• There are explanatory notes in the notes pane
• For further information on any of the content in this
slideset please contact:
Jill.Eastment@cambridgeshire.gov.uk or
Helen.Johnston2@cambridgeshire.gov.uk
3. Contents
1. Background and definitions of falls
2. Quick facts
3. Risk factors
4. Consequences of falls including fear of falling
5. Data on falls
6. Impact of falls on the health and care system
7. Guidance on measures for falls prevention
8. Evidence for the effectiveness of key interventions
9. Local falls prevention integrated framework
10. Measuring the effectiveness of falls prevention
approaches
4. 1. Background & Definitions
Falls are a major health problem in older adults
• At least 30% of persons aged over 65 years experience one
or more falls each year
• This proportion increases to 40% after age of 75
• Both the frequency of falls and the severity of
complications increase with age, level of disability, and
extent of functional impairment
Definitions
• Falls: A fall is defined as an unplanned descent to the floor
with or without injury to the patient1
• ‘Injurious falls’ and ‘serious falls’ are used variously2 where
there is an injury or the person uses health services due to
a fall
1. National Database of Nursing Quality Indicators (2011).
2. Differing definitions depending on source, different research study methodologies etc.
5. 2. Quick facts
• Falls are a major cause of disability and the leading
cause of mortality due to injury in older people aged
over 75 in the UK.
• Falls are the leading cause of injury-related
hospitalisation in older people and are a common
reason for older people requiring long-term care in
their home or a residential facility.
• Up to 90% of older patients who fracture their hip fail
to recover their previous level of mobility or
independence
– Only 46% of older people with a fractured hip return to
their usual residence on discharge from hospital.
6.
7. 3. Risk factors for falls
Intrinsic risk factors Extrinsic risk factors
A history of falls Environmental hazards (poor lighting, slippery
floors, uneven surfaces, etc.)
Age Footwear and clothing
Gender Inappropriate walking aids/ assistive devices
Medicines including benzodiazepine,
psychotropics, class 1a anti-arrhythmic
medications, digoxin, diuretics, and sedatives
and polypharmacy
Medical conditions including circulatory
disease, chronic obstructive pulmonary
disease, depression, arthritis, incontinence
Impaired mobility and gait
Visual or cognitive impairment
Foot problems
Malnutrition, vitamin D deficiency
Psychological status – fear of falling
Established risk factors for falls
Source: Adapted from 2004 Health Evidence Network Paper for the World Health Organisation
8. 4. Consequences of falls
• Injuries due to the fall
1. Fractures
• Wrist, spine, and other fractures
• Hip fractures
2. Other injuries
• cuts and lacerations
• pain and distress
• Fear of falling and wider psychological impacts
Loss of confidence may result in future activity avoidance, limiting social
opportunities, independence, and ability to get out and about
• Reduced independence and increased reliance on formal
and informal carers
• Anxiety for family and friends and carers
• Increased requirement from support by health and social care services
9. 5. Data on falls in Cambridgeshire
• Overarching indicators – hospital admissions due to falls
Injuries due to falls in people aged 65 years and over
Hip fractures in people aged 65 years and over
• Comparison with other areas
• Trends over time
• Where do people fall? - location
• When do people fall? - seasonality
• Limitations of the data
11. Overarching indicators: hip fractures
http://www.phoutcomes.info/Public Health Outcomes Framework
By Region
By District
12. Injury due to falls in people aged 65 and over
Source: Public Health England (PHE). Primary diagnosis code for Injury (ICD 10 S00-T19) with falls code (WOO-W19) anywhere in diagnostic string.
Where the primary diagnosis (main reason for hospital admission) is an Injury code
and a falls code has been included in diagnoses 1-12
13. • Around 2,450 admissions per year in Cambridgeshire
• Around 660 admissions per year in Peterborough
• 71% in over 80s
• 70% in women
Key data on injuries due to falls 2014/15
14. Rate of hip fractures in people aged 65 and over
Source: Public Health England (PHE) Primary diagnosis ICD 10 S72.0, S72.1, S72.2.
15. Key data on hip fractures 2014/15
• Around 630 hospital admissions per year in
Cambridgeshire
• Around 190 hospital admissions per year in
Peterborough
• 72% in over 80s
• 73% in women
• More than 93% are coded as having experienced a fall
16. Type of fall and place of fall (ICD 10)
How do older people fall?
• Slips and trips: 53% in 65-79 and 40% in
over 80s
• Falls on same level 13% in 65-79; 22% in
over 80s
Where? Majority of older people fall at home
18. Limitations of data on falls
• Falls: coding is known to be variable between hospital trusts, although
this is thought to have improved. Some artefact of coding is likely
nationally.
• Hip fracture: fractures are coded but there is little further detail in the
data (such as the place, ‘cause’ of the falls)
• Considered an important proxy metric for serious falls.
• Note relatively small numbers when broken down further eg. by
place.
19. 6. Impact of falls on health and care
• In 2013, results were published from a Scottish study which aimed to
estimate the costs to health and social care services in managing older
people who fall in the community
• The study demonstrated that 34% of people aged 65 years and over living
in the community fall at least once a year, of which 20% contacted a
medical service for assistance.
• Applying these results to local population figures for Cambridgeshire &
Peterborough CCG, it is estimated that falls in in 2016 will result in over:
5,500 GP attendances
8,700 ambulance call outs
6,300 A&E attendances
3,000 inpatient admissions
• The associated costs are high and estimated to be over £83 million.
• Costs at discharge are predominantly associated with social care (but not
from the funder perspective)
Source: Local analysis based on Craig J, Murray A, Mitchell S et al. The high cost to health and social care of managing falls in
older adults living in the community in Scotland. Scottish Medical Journal 2013;58(4):198-203
20. 7. Guidance on measures for falls
prevention
• NICE 2004 Clinical Guideline (CG 21) replaced by an extended Clinical Guideline in June
2013 (CG161) Falls: assessment and prevention of falls in older people.
• The key recommendations from NICE comprise:
Preventing falls in older people
Case or risk identification
Multifactorial risk assessment
Multifactorial intervention programmes:
Information and education:
Professional education
Preventing falls in older people during a hospital stay
Predicting patients’ risk of falling in hospital
Assessment and interventions
Information and support
National Institute for Health and Clinical Excellence (NICE): Clinical Guideline (CG161) Falls: assessment and prevention of
falls in older people. 2013. Available at: https://www.nice.org.uk/guidance/CG161
22. 8. Evidence for the effectiveness of key
interventions
Cochrane Review: preventing falls in older people living in the community
Effectiveness
• Group and home-based exercise programmes, and home safety
interventions reduce rate of falls and risk of falling.
• Multifactorial assessment and intervention programmes reduce rate of
falls but not risk of falling
• Tai Chi reduces risk of falling
Economic evidence
Three interventions for preventing falls in community-living older people have
indicated cost savings:
• home-based strength and balance exercise (the Otago Exercise
Programme) in over 80-year-olds
• home safety assessment and modification in those with a previous fall
• specific multi-factorial programmes
Gillespie et al. Interventions for preventing falls in older people living in the community. Cochrane Database of
Systematic Reviews 2012, Issue 9.
23. 9. Local integrated framework
Primary prevention in the
community (untargeted
interventions) 65+
Identification
& Assessment
Targeted interventions
At risk/frail or post-fragility
fracture/75+
Preventing falls in hospitals &
LTCF
Post-discharge (towards
independence)
P.1 Exercise
Focused on gait, strength,
balance, or functional
training
Otago
Tai Chi
IA.1 Older people routinely
asked whether they have fallen
in the past year
TI.1 Multidisciplinary assessment PS.1 Regard at risk of falling in
hospital:
• All patients aged 65+
• Patients aged 50 to 64 years
who are judged by a clinician to
be at higher risk
PD.1 Home hazard
assessment and safety
intervention/ modifications
by a suitably trained
healthcare professional.
P.2 Vitamin D supplementation
(+ Calcium)
IA.2 Older people reporting a
fall or at risk of falling observed
for balance and gait deficits
and considered for
interventions to improve
strength and balance.
TI.2 Considered for an
individualised multifactorial
intervention
PS.2 Multifactorial assessment PD.2 Specific exercise
programmes (eg Otago)
IA.3 Healthcare professionals’
professional competence in
falls assessment and
prevention.
TI.3 Strength and balance training
is recommended - individually
prescribed and monitored.
PS.3 Multifactorial interventions
(include individual risk assessment
and tailored interventions)
IA.4 Multifactorial falls risk
assessment
TI.4 Psychotropic medications
reviewed, and discontinued if
possible.
PS.4 Multifactorial interventions
with an exercise component in
extended care settings.
IA.5 Strength and balance
training.
TI.5 Cardiac pacing considered for
older people with cardioinhibitory
carotid sinus hypersensitivity.
PS.5 Vitamin D supplementation
TI.6 Falls prevention programmes
(includes behaviour change &
addressing barriers)
PS.6 Early anticipation of
discharge needs
TI.7 Education & information. PS.7 Information & support
PS.8 Ensure that relevant
information is shared across
services.
PS.9 Medication reviews for
residents in LTCFs
Lifecourse approach
L.1 Physical activity for bone and muscle strength: children and young people (5-18 years) vigorous intensity activities, at least three days a week; adults (19-64
years) activity to improve muscle strength at least two days a week
24. 10. Measuring the effectiveness of falls
prevention approaches
Public Health Outcomes Framework
• Injuries due to falls
• Hip Fractures
Service indicators:
• Incidence of hip and fragility fractures in people aged 65 and over
• Percentage of individuals aged 65 and over who have experienced a fall
who experience another fall which results in injury within six months
• Measurement of confidence and level of fear for an individual after a fall
in people aged 65 and over
Tools:
• Tinnetti confidence index
• Patient reported outcome measures
• Validated quality of life scales: EQ-5D; SF-6; SF-12; SF-32; WEMWBS etc.