Nan Roberts Community Hostel

Falls reduction program

Nan Roberts Community has implemented a falls reduction program, which was developed from the benchmarking of resident accidents with other organisations and a desire to improve performance.

While the falls rate for Nan Roberts Community was not the worst in the benchmark group, our quality assurance committee agreed that further investigation was necessary. Initial research focused on whether falls were occurring at certain times or in specific locations but there were no identifiable trends. The quality assurance committee then decided that a visit to another facility that was achieving results below the mean would be appropriate. The purpose of the visit was to look at falls incident reporting, the physical layout and environment of the facility, staff rosters and hours, RCS levels and to investigate any differences in these areas that could help explain an adverse falls rate. The only substantial variation that could be confirmed was the fact that the other facility was running a physical therapy program. A literature review followed and confirmed that a physical therapy program could potentially have great benefits for some residents through a reduced falls rate.

Implementation involved identifying those residents with a history of falls and who would benefit from the program. The program was then rolled out in three groups over a 12 month period. Each resident has an individual assessment conducted by a physiotherapist with the development of specific exercises and goals.

A care service employee was trained to deliver the individual programs to each resident over 15 weeks. After 15 weeks the residents move to a maintenance program where group exercise classes are conducted five times per week by the activities staff.

The physiotherapist reviews progress towards goals at end of the initial 15 weeks and six monthly intervals (or earlier if necessary).

The effectiveness of the program is being measured and monitored in two ways. Firstly, data is kept on the falls rates for each group to determine if there has been a reduction in falls. There has been an overall reduction of 20% in the falls rate to date for those residents participating in the program. Falls rates six months before and after commencement of the program were maintained to ensure there was sufficient data on which to make comparisons with.

Secondly, individual achievements are recorded to determine if the resident's mobility/dexterity has improved. Some of these achievements include:

• now able to stand in shower
• walking more confidently and much further with a walker
• now walking a short distance with a walker (was in a wheelchair at the start of the program). Now managed by one staff member and not two
• balance for one minute without aids
• discarded four-wheel walking frame and now using a walking stick.

Many residents have enjoyed participation in the program and the variety it has added to the activities program. In addition to this there is the anecdotal evidence from resident comments that their confidence has improved.

From the home's perspective it is this improved confidence and the individual results that have made the program worthwhile and not necessarily the overall reduction in fall rates.