MECRS Fall Prevention Project

Background

Program Goals:

Melbourne Extended Care and Rehabilitation Service (MECRS) (Melbourne, Australia) – A multidimensional initiative to design, implement and empirically test a balance and multi-pronged program for reducing falls in health care settings

Intent:

Unintentional

Risk Factors Addressed:

Environmental hazards on the ward, improved communication with staff, patients with inappropriate footwear and clothing; medication, nutrition, mobility and gait aids, fear of falling

Place of occurrence:

Hospital settings

Age/Age Range:

65+

Other Population Characteristics:

Lack of strength, agility, ability to exercise; foot problems requiring podiatry care.
Falls in sub-acute and rehabilitation settings can be associated with complications, psychological effects, permanent institutionalization, can extend the length of stay or necessitate diagnostic procedures 

Resources

Year Developed:

2000MECRS Falls Prevention Project
The  MECRS/National Ageing Research Institute Falls and Balance Clinic were the first fully multidisciplinary specialist Falls and Balance Clinic developed in Australia commencing operation in 1988 

Collaborative Organization(s):

Department of Human Services (DHS) Quality Improvement Funding (QIF)
National Ageing Research Institute 

Funding Resource(s):

The Program was built on developmental activities already in existence at the institute. This aspect was funded by the DHS Aged Care Division at Melbourne.
The program itself was funded by the Department of Human Services Quality Improvement Funding 

Implementation

Context/Setting:

In hospital

Strategies Used:

Education, Engineering, Economic

Activities Used:

Staff training (SPLATT Attack), Advanced Falls Prevention Trainee program, action research, patient and career focus groups, validation and implementation of a falls risk assessment tool, an environmental safety audit process review, podiatry audits of patients’ feet and footwear problems, review of nutrition and falls risk of patients, bed/chair alarm trial, fear of falling review in rehabilitation patients, and an interaction with falls prevention activities within the acute setting at Melbourne Health

Program Evaluation:

Advanced Falls Prevention program rated very good or excellent by those attending the session – follow up meeting held to identify actions being undertaken and barriers to activities; Environmental safety audit tool ensures relevant falls prevention strategies are fully incorporated; Nutrition audits indicated those with an increased risk of falling also had an increased risk of malnutrition; Podiatry audits to review feet and footwear problems; Fear of falling review among rehabilitation patients is ongoing

Source of Best Practice:

Volpe, R., & Lewko, J. (2007). A Sourcebook of Evidence-Based Practices in the Prevention of Severe Injuries.

Original Source:

Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (1999). To Err is Human: Building a Safer Health System. Committee on Quality of Health Care in America. Institute of Medicine, National Academy Press

Supplementary Material:

N/A

Local Example(s):

National Steering Committee on Patient Safety. (2002). Building a Safer System: A National Integrated Strategy for Improving Patient Safety in Canadian Health Care. Report on Patient Safety.

Contact Information: 

Keith Hill
National Aging Research Institute
34-54 Poplar Road
Parkville, Victoria
Australia 3052
Email: k.hill@nari.unimelb.edu.au
Tel: 038-387-2614

Outcomes

Long-term outcomes/Effectiveness:

SPLATT Attack program in use in other hospitals

Short-term outcomes:

Advanced Falls Prevention Training program was rated as very good or excellent by participants.
The action research component yielded several problems related to falls; strategies to address shoes, clothing, communication, environmental hazards were developed.
Links between nutrition and falling were made
Recommendations for fall prevention education were obtained via family/career focus groups

Other

Date of Review:

2005

Classification:

Best Practice