APRILFALLS LINKS. Falls Prevention is everyone s business. Welcome April Falls Day /Month. Moving right to stay upright. fallsnetwork.neura.edu.

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1 APRILFALLS LINKS 1 Volume 12 April Falls Issue 2017 Newsletter of the NSW Falls Prevention Network Welcome April Falls Day /Month Special Edition Falls Links Newsletter This newsletter highlights some of the activities that occurred in NSW Local Health Districts throughout April 2017 as part of We thank all staff and organisations who actively participated in April Falls Day / Month activities in hospital, community and residential care services in their Local Health Districts. We also thank the LHD Falls Prevention Coordinators and other staff who collated and forwarded April Falls reports and photos. Tai Chi demonstration at Port Kembla Hospital Inside this Issue CEC April Falls Day Moving right to stay upright April Falls Day /Month Reports from LHDs 4 Falls Network Information 30 fallsnetwork.neura.edu.au Falls Prevention is everyone s business

2 2 This year s theme was focused on Mobility and Falls Prevention. Poor balance and strength will affect a person s mobility and put them at an increased risk of a fall. In hospital a person s mobility may be reduced due to the effects of medications (including anaesthetics), acute events and illnesses (e.g. stroke, hip fracture, and infection), cognitive impairment and/or delirium. Balance and mobility may further deteriorate during a hospital stay if a person is less active. The CEC supported LHDs with resources for April Falls Day - including: Poster and flyers for patients, family, carers and staff. NSW Health Staff had access to PowerPoint Presentations for Staff education New videos included: Safe Use of Mobility Aids Videos These videos include a physiotherapist demonstrating with a client the safe use of mobility aids, including how to adjust it to the correct patient height, safety check and safe mobilising techniques. The mobility aids included are: rollator frames, forearm support frames, walking stick and, wheeled walker. Balance and Strength test videos These videos demonstrate balance and strength tests including 5 x sit to stand, 10m walk test, alternate step test, near tandem stance test and timed up and go. It demonstrates the test, outlines the equipment needed and explains the results and when a person should be referred to a physiotherapist or exercise physiologist or a Falls Prevention exercise program. Mobility resources coming The CEC have been working on a number of Mobility resources. The NSW Falls Prevention Network members will be informed once they are finalised. NSW Falls Prevention Network

3 3 The CEC April Falls Month Competition We were encouraged by the number and quality of the competition entries. The entries this year had some common themes that had shown to reduce falls. These included: rounding with purpose, safety huddles and post fall huddles and education of patient, family and carers on fall risk. The winners presented at the NSW Falls Prevention Network Forum in Sydney on 19 May. The presentations can be viewed on the NSW Falls Prevention Network website: The Winners were: Mr Scott McNeill, Quality, Coordinator, Excellence Champion, Manilla MPS Manilla MPS made a commitment to their residents to decrease the severity and number of falls within the facility. They used a Clinical Practice Improvement (CPI) methodology to identify the type and number of falls occurring and implemented an improvement program and evaluated the outcome. The CPI project had 3 cycles. Each cycle maintained the improvements of the prior cycle. These improvements strategies included: Education to staff implementation of falls prevention strategies correct identification of high falls risk residents/patients and care planning improving and maintaining post fall management compliance hourly rounding, safety huddles use of the Electronic Patient Journey Board flagging high falls risk patients and high fall risk rooms developed hourly rounding presentation to support staff with rounding with purpose. As well as reducing the number of falls over a year. Manilla MPS have reduced their SAC 2 falls from 7 in 2015 to 0 in Ms Elizabeth Endean, Aged Care CNC, St Vincent s Hospital. The Acute Aged Care ward of St Vincent s Hospital introduced a multidisciplinary Falls Huddle on all patients who fell. Each huddle reviews the fall event, medical record and any contributing factors (cognition, medications, continence, mobility and a review of the environment). Delirium and cognitive impairment was a contributing factor in 96% of falls. The outcome of a falls huddle is an individualised Falls Prevention and management plan and its implementation. Following the implementation of the Falls Huddle falls have reduced by 31% and the lessons learnt were: Falls Prevention is multifactorial and multi-disciplinary appropriate recognition, prevention and management of delirium is essential review of the environment is an important component to Falls Prevention there is more to falls prevention then completing a Falls Risk Assessment tool. NSW Falls Prevention Network

4 4 Northern Sydney Local Health District Summary of April Falls Activities Acute/Sub-Acute Facilities: A bright orange April Falls Day and Month 2017 was celebrated across NSLHD. All our hospitals as well as some of our private hospitals, and many of our community health teams who work with older clients/patients, participated in our annual celebration of April Falls Month to spread the theme of safe mobility Moving right to stay upright : Take steps to prevent a fall. The new CEC Safe Mobility Education Videos were promoted to both hospital and community settings. Also highlighted was that within Mental Health and Drug & Alcohol (MHDA) - the average age of falls occurs from 56 yrs of age. An extensive staff April Falls Education roadshow was delivered to staff of MHDA inpatients and community (paediatric, adult, and SMHSOP teams) across all of NSLHD. The NSLHD April Falls Month Competition for the service able to demonstrate cost effective ways to reduce falls. A cash prize of $1000 was allocated to be spent on falls prevention equipment. The winning initiative was from Royal North Shore Hospital, submitted by Melissa Passer. The entry detailed three strategies; Falls Safety Huddles; a Falls Prevention Information Wall for staff and patients/carers; and implementation of a policy of unrestricted visiting to allow patients with acute confusion, delirium or known chronic illnesses to be comforted and supported by their relatives and carers. With the prize money they will purchase a recliner chair for Carers. Key activities across the LHD inluded; Falls prevention promotion displays in hopital foyers and/or wards using the colourful balloons, flyers and posters. In-service education, poster and quiz competitions with prizes etc were some of the activities around the district. Local media coverage was excellent. Northern Sydney Home Nursing Services, and Community Health teams, including MHDA, conducted education sessions and distributed lots of information to their consumers and staff during the month. April Falls Forum The Sarcopaenia and Falls Prevention Seminar and Expo was a great success with over 160 participants from hospital, community, Community Service Providers and staff of RACF s. NSW Falls Prevention Network

5 5 Topics and activities included: Sarcopaenia, and its management presented by Prof Sue Kurrle and nutritional perspectives by Megan Jones. Updates on falls and related activities in NSLHD. Expo stall holders from Health, CEC and NGO Community Service Providers. Great networking and sharing of resources. All talks and April Falls resources are available on the Northern Sydney Health Promotion website. Clinical Practice Changes Implemented over the past 12 months Implementation of post fall safety huddles. Pre-falls safety huddle project at Riverglen, psychogeriatric ward in Greenwich Hospital. Review of all SAC1 and 2 falls for 2016 highlighting areas of opportunities for improvement. Successful Standard 10 accreditation feedback for the 3 facilities surveyed in Joint project with the GIO and NSLHD Work Health and safety re Slips, Trips and Falls for hospital volunteers. Volunteer education on falls prevention nis ow provided at each major facility orientation bi-annually, and more often as required. Stepping On extended to include CALD and SMHSOP goups. Plans for Improvement over the next 12 months Hospital based initiatives to meet the Leading Better Value Care -Falls in Hospitals initiative project. These will include facilitating intentional rounding, further roll out of safety huddles, falls champion programs, staff education, promotion of safer mobilisation and management of cognition/ delirium and medication issues. Further planning with GIO on facilitated workshop around volunteer safety Planning with MHDA and Healthy Lifestyle re extending reach of appropriate physical activity classes to younger MHDA consumers. NSW Falls Prevention Network

6 6 South Eastern Sydney Local Health District Hospitals/Services that Participated in April Falls Day Promotions: St George Hospital April Falls Day activities were held at St George Hospital on Wednesday 5th April Falls prevention key messages were promoted on this date during the annual walk around was conducted to promote falls prevention. This concept was implemented at St George Hospital in 2015 as a strategy to improve the engagement of clinical staff in the promotion of falls prevention initiatives. it has been a highly effective strategy for improving staff awareness of the scope of the issue, and communicating falls prevention messages. April falls activities included: The recently endorsed Standardised Mobility Terminology for use across SESLHD guideline was promoted. Lanyard cards with the new mobility terminology definitions were distributed to staff. A jelly bean guessing competition, with the number of jelly beans in the jar corresponding to the number of falls reported at St George Hospital in Recently finalised Storyboard for falls risk assessment and screening for confusion and delirium posters were distributed to wards for display. This poster outlines the various documents available to assess and manage a patient s falls risk during admission to hospital. CEC falls prevention brochures for patients/ carers were also promoted. 1:1 staff education to ensure clinicians understood when and how to complete falls risk assessments, cognitive screens and implement and document appropriate falls prevention strategies. Clinical Practice Changes Implemented over the past 12 months St. George Hospital has reduced fall rates over 6 consecutive months, from November 2016 April 2017 (average = 72 falls per month. Storyboard for Falls Risk Assessment and Screening for Confusion and Delirium poster to guide staff re: falls risk assessment and management finalised and implemented. A SAC1 and SAC2 Fall Incident Recommendation Monitoring Log has been implemented. This log is tabled at the Falls Prevention and Management Committee meeting each month, and falls champions who attend the committee meetings are responsible for feedback regarding the implementation of incident recommendations that have occurred in their clinical area. SESLHD Guideline for Designated High Risk Observation Rooms (Adult Inpatients) has been finalised and implemented. SESLHD RACF Transfer/ discharge summary form has been revised to incorporate more detail of patient s falls risk assessment, history of falls and prevention strategies, to improve the communication of this information on discharge from hospital to RACF. SESLHD person-centred profile and TOP 5 form have been implemented across the organisation to improve communication, care and management of patients with a cognitive impairment. SESLHD 4AT Rapid assessment test for delirium has been implemented across the organisation to improve the identification of delirium. Monthly review of falls rates,facility and ward/ unit, has continued, and is communicated to the wider organisation through the committee membership. NSW Falls Prevention Network

7 South Eastern Sydney Local Health District 7 Hospital orientation falls prevention education session has been updated for Improved compliance with the completion of the three falls modules in HETI has also been noted. Annual organisational post fall audit completed in November 2016, and demonstrated a significant improvement in the completion/ revision of the FRAMP post fall, from 50% in 2015, to 80% in December CENS falls audit results highlighted greater than 90% compliance with the requirement for patient s falls risk status to be communicated as part of clinical handover. Revised St George Hospital Patient Handover Care Plan form implemented in February 2017, which includes significant improvements to the falls risk and cognition sections. Multidisciplinary post falls huddles were introduced in the Rehabilitation and Aged Care Wards. Plans for Improvement over the next 12 months Wider implementation of multidisciplinary post fall huddles across the organisation. Continued focus on improving the identification, assessment and management of delirium across the organisation. Continue sharing and networking of quality improvement initiatives relating to falls prevention. Sutherland Hospital Committee ran April Falls Day displays and competitions in the Atrium of Sutherland Hospital. Changes implemented over the past 12 months Staff and visitors have an increased awareness of fall prevention strategies and the availability of community exercise programs. Reviewed falls prevention program for mobility group to make the exercises more evidence-based and challenging, reviewed our outcome measures to include rate of falls prior to attending the program and up to 12 months after completing the program. Plans for improvement over the next 12 months A submission for funding to start a Dance moves for falls prevention program in the inspiring ideas challenge in SESLHD. Calvary Hospital Kogarah April falls activities: Fall Prevention display board placed in the hospital foyer, posters and balloons displayed around the hospital andinformation flyers displayed for patients and visitors. Launch of the new SESLHD Mobility Terminology Guide including new colour (orange) mobility identification card to define Stand by assist. Nursing education targeted on falls prevention and completing Ontario falls risk screen and FRAMP. NSW Falls Prevention Network

8 8 South Eastern Sydney Local Health District All Transitional Aged Care Clients in the community received a falls prevention pack, including information sheets, exercise programs and pens. Inpatients Falls afternoon included an educational talk to patients and their carers, a themed Trivia quiz, balloon tennis and bowling tournaments. Consumer engagement survey post inpatient fall. Walk around compliance audit completed. Changes implemented over the past 12 months Hospital wide we have reduced our average falls rate from 7.1 to 4.9 per 1000 OBDs in the last 12 months. Implemented community falls risk assessment and management guidelines in community teams. Implemented new mobility definitions to ensure handover language is standardised. This has included adding an orange mobility card for stand by assist to the traffic light system for identifying patients mobility status. Reviewed the safety huddle procedures to ensure they are completed within 24-48hrs of a fall occurring. Improved the lighting throughout the hospital. Plans for imrpovement over the next 12 months Implement post fall safety huddles on the Palliative Care Wards. Produce an orientation pack for new staff on fall risk assessments and management procedures for each ward. Implement a procedure around management of fall prevention equipment e.g. sensor mats. Work with consumers to identify the best methods of involving them and their family in their care. War Memorial Hospital Community Health Promotion talk on Foot Health by Podiatrist. Combined Teams presentation on Falls from patient perspective by CNC and PT. Presentation by Physiotherapy Manager, on the new SESLHD Guidelines - Standardised mobility terminology for use across SESLHD. Walk arounds by Falls Advisory Committee members to raise awareness on falls prevention. Changes implemented over the past 12 Months Increase compliance with completion of Falls Risk Assessment and Management Plan (FRAMP). Falls huddle strategy using falls huddle template implemented. Review strategies to minimise falls within facility based Transitional Aged Care Program. Plans for improvement over the next 12 months To educate staff/patients/carers on the risk of wearing socks on the wards and contributing falls. Monitoring of completion of Falls Risk Assessment and Falls Huddle documentation. NSW Falls Prevention Network

9 9 South Eastern Sydney Local Health District Use of Electronic Patient Journey Board to identify high falls risk patients. To promote and provide education on the new SESLHD Guidelines on mobility definitions and 6 Monthly evaluation of use of this Guideline. Prince of Wales Community Health April Falls 2017 was used as an opportunity by the POW CH falls prevention committee to promote to clinicians, clients and consumers the 2017 theme moving right to stay upright.the month commenced with a consumer promotion in the Barker Street Foyer where consumers were offered the four step balance test as a way to test their balance. How do l move right to stay upright? 33% ofthe 16 consumers tested could not complete the test and were given advice by clinicians on strength and balance exercises. A prize was donated by the POW Foundation as an incentive to take part in the test. Consumers were also given a copy of the Staying Active and on Your Feet booklet Launch of the recently updated POW Community Health locally education resource The Management of Falls Risk Factors. Clinicians were then invited to a live practice session where they participated in walking the talk a session delivered by a guest physiotherapist which included Tai Chi style exercises involving step and gait changes. Clinicians found themselves on the receiving end of instructions. There was lots of laughter and appreciative understanding of what clients can experience when trying to move right to stay upright. Falls Prevention committee members took to the road informing their teams about all the resources available to assist them in helping their clients to prevent falls. Clinicians were educated about the availability and how to access the many resources on the Clinical Excellence Commission (CEC) website. These included Community Care Moving Right to Stay Upright powerpoint presentation and particularly the videos showing Safe use of Mobility Aids and Balance and Strength Test videos. NSW Falls Prevention Network

10 10 Western Sydney Local Health District WSLHD used April Falls Month as an opportunity to reduce falls in its hospitals and community, hosting forums for clinicians, in-hospital stalls, exercise displays, information sessions for staff and the community and flash mob for community members highlighting importance of balance and strength. These various falls prevention activities were held in Auburn, Blacktown, Mt Druitt, and Westmead Hospitals and in the local community. At the Local Health District level, April Falls Splash Screen Messaging ran across the district leading to April Falls Day. Posters for this year, Balance & Strength Exercises for Seniors Fridge Magnets and other resources were sent out to various facilities. Western Sydney Preventing Falls Forum Around 80 people attended this forum held on Thursday, 6th April 2017 at PARC Building, Cumberland Hospital. The day included presentations and updates from all facilities which also covered community and population health and nutrition and mobility. Staff had the opportunity to participate in practical group workshops in the afternoon session. The aim was to gain practical experience in the areas of Mobility and Nutrition. This included the do s and don ts and safe use of mobility aids, strategies to deal with confused elderly patients and how to identify malnutrition. Evaluation shows that staff valued the information provided and enjoyed the practical sessions and would like to have more workshops. Flash Mob with older people WSLHD encourages older people to keep active mastering a few simple strength and balance exercises. April was the great opportunity for older people to sign-up to the district s popular Healthy Older People Partnership (HOPP) program, ahead of the winter chill. Dozens of HOPP partners came together in Auburn Courtyard outside the shopping centre on 20th April to show off their moves, as part of the Healthy Active Ageing Expo. The local Police commented that this was a great example of community engagement and would like to see more in the future. The flash mob was designed to raise awareness of the importance of regular exercises for older people, with participants showcasing movements like heel raises, half squats, knee lifts and walking sideways. The exercises are part of the Healthy Older People Partnership (HOPP) Project. This project is building the capacity of partner organisations to increase the number of older clients participating in strength and balance exercises. All the exercises are designed by falls prevention specialists and are ideal for older people to build good strength, and coordination, to avoid falling in their home. NSW Falls Prevention Network

11 Western Sydney Local Health District Community Health 11 Community Health falls committee held falls information workshops for community health staff to increase awareness and skills on the falls screening and assessment using FROP-COM and the referral pathway flowchart. The process will be reviewed to identify and address gaps. Blacktown and Mt Druitt Hospital Activities Blacktown and Mt Druitt Hospitals celebrated 2017 April Falls Day with much enthusiasm. At Blacktown Hospital there was a foyer display containing information on falls, exercises classes available e.g. Ready Steady Go (based at Mt Druitt Rehab Hub), Stepping On, strength and balance exercise handouts from CEC and a display of some mobility aids and assistive equipment. At lunchtime, Tai Chi and strength and balance exercise demonstrations were carried out in Hospital Street on the main stage area. At Mt Druitt Hospital, a foyer display was also provided and the rehabilitation ward conducted a fun morning of trivia, exercises and education in the dining room for the current patients. Across both sites, all patients were provided with an information sheet on Falls and a Find A Word puzzle. Westmead hospital In Month of April, Westmead activities included: On three Fridays 7th, 21st and 28th April, held falls expos for hospital staff which included information and practical stations on physiotherapy, occupational therapy, nursing, nutrition and pharmacy. Conducted four community information stalls in main foyer of hospital on 5th, 15th, 19th and 26th April to distribute information on falls prevention to patients, carers and families. This opportunity was also used to gain information on the acceptability of the falls prevention information flyers from the community members. This will guide to tailor future falls prevention information distribution. Auburn Hospital Activities As part of April Falls Day (April 3), Auburn Hospital s Falls Committee hosted a stall at the main entrance, offering education on falls prevention and treatment. The group also held a jellybean guessing competition and raised money for resources to help prevent falls across the hospital. CEC falls prevention posters were displayed at the main entrance along with patient information packs. In addition, wards got into action by decorating green and wearing green to recognise Prevention of Falls and Harm from Falls. NSW Falls Prevention Network

12 12 Nepean Blue Mountains Local Health District Nepean Hospital A number of April Falls Day educational stalls were set up in the South Block Foyer to capture high public and staff pedestrian traffic. The stalls included: Balance and strength testing, conducted by physiotherapists using the Nintendo Wii balance board. Displays and demonstrations of mobility aids and providing education and information on the correct and safe use of equipment such as walking sticks, four wheel walkers, two wheel walkers, forearm support frames, etc. Occupational therapists were also present during the day demonstrating long reach aides and sock aides. Vision Australia were present to help educate the public about the importance of vision in falls prevention. Representatives from the Stepping On program and the NBMLHD Falls and Fracture Clinic were present to inform people about their services and accepted referrals totheir programs. Dieticians, Pharmacists, Urology CNC, Dementia and Delirium CNC, and Manual Handling Coordinator were also present to provide information on their roles in falls prevention. There were also displays of falls prevention tools such as sensor mats, and chair alarms for the public to try. A falls quiz was also conducted to test staff knowledge on falls and raise awareness of falls prevention, with an Easter egg hamper as a prize. Blue Mountains District Hospital Posters and window signs promoting falls awareness were displayed all over the hospital. Interesting falls educational boards were organised by each of the wards to encourage staff, patients, and visitors to prevent falls. Creation of green room was in the East Wing which cohorts high fall risk patients and has a dedicated nurse for the room to monitor and care for patients. An afternoon tea was also organised to celebrate April Falls Day with green balloons and green drinks. NSW Falls Prevention Network

13 13 Nepean Blue Mountains Local Health District Springwood Hospital Sessions about strength and balance testing were organised by the staff of the Hospital. Flyers and information materials were given out and Falls prevention awareness posters displayed across the hospital. Lithgow/Portland Hospitals Falls prevention and awareness posters were displayed all over the hospital. Flyers about proper footwear, vision, nutrition, how to get up after a fall, strength and balance testing, etc. were distributed as well. Community Health Centres (Lawson, Springwood, Lemongrove) Posters regarding falls prevention were displayed in the Community Health Centres. An in- service regarding falls prevention was also conducted at the Lawson Community Health Centre. Clinical practice changes implemented over the last 12 months Top 5 implemented to engage with carers for people with dementia. Promotion of the use of falls prevention equipment such as chair alarms, sensor mats. Creation of Close Observation Bay in W3B where high falls risk patients are monitored closely by a dedicated nurse. A Post Fall Huddle project is currently under development to be piloted in a number of wards across the LHD. Plans for improvement over the next 12 months Assess educational needs of staff regarding falls. Conduct a full day falls workshop which will include: falls assessment, falls prevention, management and appropriate documentation of falls, and work health safety issues in falls. Continue falls prevention awareness and provide strategies to wards to prevent patients from falling including community and nursing home visits. Initiate projects to improve falls prevention, awareness, and management such as clutter free environment, creation of falls room, etc. Work closely with community and other health facilities and providers to increase falls prevention awareness. Provide support to the LHD Primary Care and Community Health Services in relation to falls as they align with the National Standards. Implement Post Fall Huddle project in selected wards in the LHD. NSW Falls Prevention Network

14 14 Western NSW and Far West Local Health Districts April Falls Activities Promotion of AFD activities to all Health Service Managers. Copied and laminated CEC April Falls Posters and sent out to all sites to assist in local promotions. Purchasing falls bed and chair alarms for a number of sites (currently committed over $90,000 towards equipment for sites to use in both LHD s). WIN News item - filming tai chi and home based exercises and interview discussing safe mobilisation and home safety. Prime News feature on 28th April promoting the importance of balance and strength exercises. Presentatuin to over 50 community attendees at a Falls Prevention Day organised by a coomunity based home care provider Living Better (previously Care West). Orange HS conducted two information sessions with and knowledge cafe for staff with over 100 staff attended, stations included mobility and falls, pharmacy, carers, physiotherapy and hovermat demonstration. Lachlan, Forbes and Parkes Health Services Parkes Inpatient Unit had a very decorative ward filled with Falls Promotion Material including staff dressed in Orange promoting the 2017 theme Moving Right to Stay Upright during the month of April. A Community Awareness event was held on Thursday 6th April at Dunfords Pharmacy shopfront, involving Lachlan Health Council Members and Health Staff. The event was highly successful with many community members keen to access information on Falls Prevention strategies along with opportunities to discuss the Falls Prevention Programs offered at Lachlan Health Service. Forbes also held a Falls Prevention morning at the local chemist with Lachlan Health Council and Health staff. Clinical practice changes implemented over the last 12 months Forbes and Parkes have implemented falls huddles and falls champions. Lachlan has a falls working party including a consumer representative that meets quarterly to strategise and review falls. Allied Health Assistants participated and continued to offer Stepping On programs. Staying Active and On your Feet booklets distributed to the public. Mudgee and Gulgong Health Services Static displays in outpatient and ward areas on 3rd April in both facilities. Visit to all Gulgong Residential Aged Care clients for April Falls Promotion. Promotional resources provided to staff and patients. to staff informing and promoting new CEC resources at Mudgee Campus. NSW Falls Prevention Network

15 15 Western NSW and Far West Local Health Districts Clinical practice changes implemented over the last 12 months Hourly rounding. Falls Prevention equipment register for Mudgee. Motion sensor purchased and used. Days since last falls board Mudgee. Consultation and education by Physiotherapist to Activity Officers at Gulgong on exercise programs to support falls prevention. Gulgong commencement and implementation of CHOPs volunteer training program which hopefully will have a positive impact on falls risk through provision of additional supervision, support and activity for confused residents/patients. Gulgong working party participating in ACI MPS collaborative with 20 other NSW MPS sites to share resources and improve care in RAC. Plans for improvements over the next 12 months Strong push on falls huddles at Mudgee Campus. Mudgee: Closing gaps on Standard 10 Action plan with particular emphasis on decision making around FRAMP use on wards and staff education/training. 2 staff attended Falls Conference in Sydney in May Mudgee preliminary work towards implementation of CHOPs volunteer training program. Broken Hill Health Service April Falls Activities Awareness Day in Foyer -Jane Cain and Alyce Craker promoted falls prevention, exercise classes and strategies to improve balance and strength. April Falls Ward Display competition - with Medical, Surgical, Sub Acute Rehabilitation and Primary Health Unit participating. Medical Ward were the winners (third year running). Community Activities - Promotion of Stepping On and Falls Prevention strategies. Occupational Therapist - Sally Connell presented a session on the local ABC radio. Carers Support Promotion - Jane Cain and Alyce Craker attended the local Dementia Support Group to promote falls prevention and balance, mobility and strength exercises were promoted by the FWLHD Tai Chi Leader, Gail Turner. Ivanhoe held a community awareness day. NSW Falls Prevention Network

16 16 Western NSW and Far West Local Health Districts Far West in Focus Article - an Article showcasing the April Falls month. in Far West Focus. Colouring In Competition-for local children was conducted during ApriL 2017, gifts were provided to winners, and published in the Barrier Daily Truth. April Falls 2017 theme (Moving right to stay upright) was placed on Care Screen over the month of April. Clinical practice changes implemented over the last 12 months Purchase of Falls Prevention Equipment : Laser beam for chairs x 2 / Laser beam for beds x 2 for Medical Ward. Falls Equipment Data Base placed on common drive and updated. Paediatric Falls Program implemented (emr, Clinical notes, Hardcopy forms and portal). Purchase of bariatric non slip socks for wards. Ward (Medical, Surgical, SARU and ICU) Falls Prevention Resource Folders updated to reflect current clinical practices. Introduction of falls prevention ward champions (Medical, Surgical, SARU). September 2016 NSW Falls Prevention Network FWLHD Falls Forum: sharing local initiatives information resources and networks to encourage best practice. December 2016 Awareness in Foyer to promote Ruby Red Socks. Ward usage has increased greatly and BHHS Kiosk selling socks to the community. Plans for improvements over the next 12 months Community Nurses Falls Prevention Home Assessment /Falls Prevention package implementation. Falls Prevention Discharge Packages Introduction of Falls Prevention Packages to be distributed in Emergency, ICU, Medical, Surgical and Sub Acute Rehabilitation Unit. Plan for the introduction of a Falls and Dementia CNS2 for FWLHD to implement, educate and review falls and cognitive care practices within the service. Ivanhoe Health Service April Falls Activities Distribute Staying active and on your feet booklets and falls prevention home exercises leaflet. Provide verbal education to individuals, ensuring they understand and can demonstrate the home exercises. Falls prevention education material, playing on television in waiting room. NSW Falls Prevention Network

17 Western NSW and Far West Local Health Districts 17 Completion of falls risk home assessments, providing assistance and education about safety around the home. Falls prevention education billboard. Falls Prevention policies provided to all staff members of the Health Service to read, and use as reference. Education Session, including demonstration of home exercises provided to all members of the Ivanhoe Health Service team as well as to members of the community. Clinical practice changes implemented over the last 12 months Implementing falls risk assessments in the home. Incorporating falls risk assessments into patients presenting to the Emergency Department as per policy. Improved community awareness, education and supply on non-slip socks for those at risk of falls. Improved understanding of falls and falls prevention for all staff and community members. Plans for improvements over the next 12 months Continue to provide education to individuals identified as at risk of falls. In the form of distribution of staying active and on your feet booklets as well as verbal and instructional education by staff members. Liaising with and working as a multidisciplinary team to ensure optimal care is delivered to clients in the community as well as patients in our care in the Emergency Department. This includes, our Aboriginal Health Care Worker, Registered Nurses, RFDS Doctors, Maari Ma clinicians, as well as all members of the Ivanhoe Health Service and other specialist services. Any new identified clients classified as high risk in the community to ensure, falls risk assessments are provided. NSW Falls Prevention Network

18 18 Southern NSW Local Health District April Falls posters were sent to 61 wards/services across SNSW LHD for display and promotion. Staff education sessions were also held. All SNSW LHD computer screens had an April Falls message displayed throughout the month. Clinical Practice Changes Implemented over the past 12 months The LHD has finalised - Procedure: Falls Prevention and Injury Prevention for people attending SNSW LHD Community Health Services. Post Falls Management Powerform has been added to EMR2 to assist in documenting outcomes following a fall. NSW Falls Prevention Network

19 19 Southern NSW Local Health District The LiFE Program trial was successfully completed. Using the findings of the SNSW LHD project, the local Primary Health Network was successful in gaining funding to continue the program across the region. All sites/wards in SNSW LHD undertook observational falls audits using the QARS (Quality Audit Reorting Scheme) system in April. Plans for Improvement over the next 12 months Implementation of Procedure: Falls Prevention and Injury Management in for patients/residents admitted to SNSW LHD facilities. This procedure and associated support resources will align with EMR2. Implementation of a revised falls plan at Bega Valley Health Service. Undertake 22 Stepping On Programs across the LHD. Maintain the 60 existing Tai chi for Arthritis leaders and classes across the LHD. Provide update and new leaders training in NSW Falls Prevention Network

20 20 Murrumbidgee Local Health District April Falls Activities Resource pack sent to each facility. The pack included AFM resources (developed by CEC), balloons, pens, t-shirts etc. Sites did their own activities using these resources e.g. decorating reception and waiting rooms, wearing AFM t-shirts, cutting orange cake, distributing resources to patients, families and carers. District wide quiz competition for patient/visitors at the waiting room. There were 20 completed questionnaires who received a gift box with falls prevention items. Payslip AFM message for 4 weeks starting from 1 April. April Falls Month logo placed as desktop wallpaper on each computer. A number of Executives used this logo under their signature panel including our CEO. A videolink education session for staff was conducted by a local Geriatrician, Senior Physio and District Aged Care CNC jointly delivered presentations on cognition and mobility. AFM resources were distributed to community members through volunteer, tai chi, community exercise and aqua leaders. Article was published in the MLHD monthly newsletter. A media release was posted to all newspapers across the District. The physical activity volunteers organised a community gathering in Tumut to which the Cluster Manager and Tumut HS Manager attended. Around 50 people attended the program which included resource sharing, gentle exercise demonstration, and a short presentation by a local physiotherapist. Morning tea was sponsored by the Get Healthy Service. The presence of Health Service Managers as well as a LHD representative gave lots of value to this event. This showcased how strongly local health service and community work together to achieve our goal of improving the health and wellbeing of the community. Health Service Managers and LHD representative demonstrated great appreciation for the network, and will be sharing with Adelong and Batlow Managers to replicate the model. Photos were taken and sent to public affairs for publication. NSW Falls Prevention Network

21 21 Mid North Coast Local Health District April Falls activities Congratulations and a job well done to all the MNCLHD staff who organised and participated in the April Falls Day activities across the district. This year s theme was: Moving right to stay upright, and provided a great opportunity to promote falls prevention and harm from falls across our district and community. Wauchope District Memorial Hospital The 3rd April 2017 was a day of recognition, awareness and education. It was a great opportunity to reinforce and reskill staff on the importance of falls education. Port Macquarie Community Health The Aged Care team set up a very informative staff display in the stairwell. Falls prevention presentations were also provided by the Aged Care OT s and Community Physio to the Social Seniors group at Port Macquarie and Camden Haven. Port Macquarie Base Hospital Ward 3D/MAU celebrated by organising a staff and patient afternoon tea. Their can-do, multi-disciplinary approach included an interactive exercise circuit run by physio Irene Dowton, educational information and flyers as well as a delicious chocolate cake for all to share. NSW Falls Prevention Network

22 22 Mid North Coast Local Health District Kempsey District Hospital The Inpatient and Rehab Units had a display board and afternoon tea which included a best falls jingle competition, falls crosswords and word search with prizes for those who attended. Staff also wore the green falls prevention t-shirts. Coffs Harbour Health Campus There was a display board and table in the main foyer. The Acute Mental Health ward had a range of activities which included Tai-Chi and a Falls Prevention Game which was designed by consumers of the mental health service, Carolyn Taylor (CSO) and Llyris Wood (CNS Mental Health), with all the images in the game having been drawn by the patients. Macksville Health Service A range of in-services including: - Falls and Parkinson s medications by the pharmacist - Falls Prevention in Hospital - Mrs Andrews Story video introduced by Prof David Oliver UK, followed with staff discussion - Barbara s Story video developed by Guys and St Thomas s NHS UK - a short innovative program about dementia and both these videos are available on the CEC website at - Presentations on OMS (emr2) and FRAMP forms (paper based), addressing care plans, signs above beds, addressing equipment, mobility, toileting, mental status, previous falls. Staff ensuring patients are wearing correct shoes, equipment are close to them i.e. buzzers, table, regular toileting, staff mindful of the medications that the patients are taking which can cause falls. Staff are aware of the falls resource folder at the educators desk. Staff have been educated on the CEC website for resources, shown the website and how to navigate. Staff distributed information to patients and families. Staff made aware of the CEC Post fall pathway and displayed around the ward. Staff adherence to the CEC Guidelines and to ensure FRAMPS are being completed on all patients in line with OMS. NSW Falls Prevention Network

23 23 Northern NSW Local Health District Summary of activities Ward/ Community Health displays and competitions, newsletters and signage. Kyogle street stall: Kyogle MPS team and Stepping On Facilitator held a stall in the main street of town to increase awareness of falls prevention and management by engaging community members. A total of 51 community members were interviewed and asked 8 questions to identify risk of falling. Clinicians took full advantage of the opportunity to provide one on one education and many resources were distributed to community members. A new Falls Prevention and Management Checklist to replace FRAMP developed and trialled in Clarence Network. Clinical practice changes implemented over the past 12 months LHD Falls Prevention and Management policy updated and disseminated. LHD Falls Prevention and Management procedures for residential aged care, community settings and inpatient services completed. Initial discussions with District Mental Health re inpatient facility falls prevention, screening and management. New community initiatives: Men s Shed and promotional information, education provided to Community Care Support Workers and Meals On Wheels workers. General Community Falls Prevention activities during Seniors Week. NSW Falls Prevention Network

24 24 Northern NSW Local Health District A planning day for Standard 10 included much exchange with clinicians regarding best screening and management practise, using EMR, safety huddles, delirium, equipment, education and resources for family/ patients/carers. Drafting of a GP Health Falls Pathway for for MNC and NNSW Primary Health Care Networks. Finalising local balance and strength information sheet. Plans for improvement over the next 12 months Leading Better Value Care - Falls in Hospital Initiative with specific ward strategies e.g safety huddles. Best Practise in Falls Prevention and Management for Inpatient Mental Health Settings. Education for Community Health staff regarding screening and management of at risk fallers as well as falls prevention for the general 65 +age (and Aboriginal 45+) group. Consistent improvement in provision of falls prevention information and resources to patients and carers. Promotion of new LHD Falls Prevention and Management policy and procedures. Engage with key Aboriginal Health staff to develop plan for general Aboriginal Falls Prevention. Continue to support staff at Ballina with Falls Prevention Clinical Leadership program. Finalise Health Pathway for MNC and NNSW LHDs. NSW Falls Prevention Network

25 Illawarra Shoalhaven Local Health District Northern Illawarra Hospitals Group Two workshops were run concurrently and repeated: 1. Moving Right to Stay Upright: Led by Allied Health PT and OT, and included mobility assessment of patients, appropriate aids for safe mobilisation. Wardmen demonstrated the use of the Hover Jack. 2. Confusion and Falls: Delirium scenario, explored screening for delirium, risk of falls in the confused patient. Pharmacy had NIMC charts made for staff to identify high fall risk medications prescribed to the patient. The Geriatrics Advanced Trainee provided medical input.. Shoalhaven Hospitals Group (SHG) April falls activities This year wards and departments undertook their own focus days during the April Falls week of 3rd to 7th April. A summary of activities undertaken across the sites and services of the SHG include: Ward decorations in green & orange. Poster displays and information / education boards - focusing on how to stay safe when mobilising. Department based green morning teas. In-service education sessions delivered by department Clinical Nurse Educators. Falls prevention quizzes. Lolly bags (tied in orange and green ribbon) and written quiz for staff all correct quiz entries to go into draw for prize! Falls badges for staff with CEC April Falls Day logo. Patients given information on preventing falls in hospitals and safe footwear and Moving Right to Stay Upright. CEC exercise and balance flyers in the foyer at David Berry Hospital (DBH). DBH - Mobility aides on the catwalk allied health team entertained with a catwalk fashion parade with mobility aids such as walking frames. They showed correct and incorrect use of several pieces of equipment down the centre of both Rehabilitation ward areas for patients and staff and outside Karinya (Palliative Care) for staff. One of the physiotherapists was MC and the catwalkers were accompanied by music. Patients were given signs with a cross on one side and a tick on the other which they could display after each model paraded. Very entertaining for patients and staff! 25 NSW Falls Prevention Network

26 26 Illawarra Shoalhaven Local Health District Shoalhaven DIstrict Memorial Hospital (SDMH) Medical wards - education from Nina Cheyne on Parkinson s disease and falls prevention, Jenny Pavey on Adult Admission assessments and risk scores as well as CNE lead education on falls prevention, management and clinical handover. Plans for improvement over the next 12 months DBH Karinya staff are focusing on ensuring that all patient areas are kept free of extraneous equipment and that ward tidies are being done each shift to reduce/minimise falls risks. DBH Rehabilitation ward has now enlisted a Falls Champion to help drive falls prevention and management on the ward. Improved use of FRAMP as part of clinical handover to reduce falls risk through management of prevention strategies. Commencement of clinical handover working party at SDMH to review all aspects of clinical handover. Ongoing implementation of multidisciplinary rounding at all sites through a variety of focuses. Already implemented are: Multi-Disciplinary Team (MDT) bedside rounding at DBH, rehab, ICU at SDMH, and daily meetings in some wards at SDMH. Southern Illawarra Hospitals Group (SIHG) Foyer display Shellharbour Hospital. April Falls Day SIHG Newsletter. Foyer display Port Kembla Hospital (PKH). Tai-Chi in courtyard for patient, staff and visitors PKH. Activities for staff walker races with vision impairment glasses donated by Vision Australia / relays with impairments imposed on staff to highlight the obstacles our patients may face with mobility and a hoola hoop competition. Morning tea for staff and patients which encouraged conversations on falls awareness and strategies. Plans for improvement over the next 12 months Falls workshops have been held to develop Action Plans for each ward at SIHG. These will be monitored over the next year for updates and moving forward. Encouragement for staff to complete the HETI Falls modules on line to refresh their knowledge of the impact of falls and their responsibilities around falls prevention. Port Kembla Hospital Rehabilitation developing a plan for high risk for falls family conference to enable patient and carers to be a part of the falls risk management plan. This ensures everyone is aware of risks and agrees with the management plan. This will be evaluated for possible roll out to all SIHG wards in the future for their high risk patients. NSW Falls Prevention Network

27 Other Organisations Anglicare 27 Last year, Anglican Retirement villages (ARV) and Anglicare merged to become a much bigger organisation with more than 23 Retirement living villages, residential homes and Day Centres as well as a considerable presence in the Home Care sector. During April Falls, and in line with the theme Moving Right to Stay Upright, the new Anglicare promoted falls prevention through walkathons at the villages and residential homes. We also educated residents at many of the rest stations with balance assessments, eye glass cleaning, blood pressure checks, lower limb strengthening exercises and encouraging hydration and calcium enriched food. Many villages were supported by outside organisations, such as the Guide Dogs NSW and Comfit and Fit. The Home Care clients were given the Staying Active and on your feet book, an April Falls bookmark and a one page leaflet for staff to start a conversation with the client regarding their fall risk. It had all the elements of fun, sunshine, information and exercises to prevent falls. Southern Cross Care -John Woodward apartments April Falls Activities Information Stand Lollies bar Falls awareness talk for residents and staff Staff on the floor wore the Falls prevention shirt for the day. Plans for Improvement over the next 12 months Improve the communication between staff and the Physiotherapist, for faster mobility assessment of residents following a fall. NSW Falls Prevention Network

28 28 Other Organisations Thomas Holt Village, Kirrawee, NSW Summary of April Falls activities To recognise April Falls Day, the physiotherapy team ran the following activities to reduce the number of falls at Thomas Holt: Morning falls prevention exercise 9.30 on Jacaranda level 3 and Roden Cutler Gym Free footwear checks review of how suitable resident s shoes & slippers were at preventing falls! Grounding down yoga class with Darcy on Wednesday and Thursday in the Roden Cutler Gym. Plans for improvements over the next 12 months Continuation of the activities described above. NSW Falls Prevention Network

29 29 Other Organisations ACT Falls and Injury Prevention Program Summary of April Falls Reports The Falls Team co-ordinated displays at key health centres throughout the ACT, for a week each over the month. We also manned displays at a number of shopping centres around the ACT, where staff discussed falls risk factors, preventing falls as well as promoting our service and Stepping On (which we also facilitate during the year). We kicked off with the Seniors Expo in late March to highlight April Falls and advertised in local social media as well as on the ACT Health Intranet site which is available to the public. This will continue, as a number of community groups have approached the team to provide Falls Prevention in-services over the coming months. Clinical practice changes over the past 12 months We are in the process of implementing our new Staying Active strength and balance classes with analysis of the project underway. There has been a change to the actual strength and balance tests undertaken in the clinic, to ones that can be replicated in any arena without the need for cumbersome equipment. Plans for improvement over the next 12 months We are in the process of getting approval for our long awaited ACT Falls Prevention booklet which will provide real time information to clients and other Health Professionals. We will then be able to further develop our suite of Factsheets based on current research, which we will continue to provide to clients and Health Professionals. They will be available in media as well as paper format and be updated in real time. NSW Falls Prevention Network

30 30 Falls Network Information fallsnetwork.neura.edu.au Joining the Network To join the NSW Falls Prevention Network listserv, send an to: In the body of the message type subscribe nsw-falls-network on the next line type end Do not put anything in the subject line. You will receive an to confirm you have been added to the listserv. To unsubscribe send an to: In the body of the message type unsubscribe nsw-falls-network on the next line type end If you have any problems, contact Esther Vance at NSW Falls Prevention Network Background The NSW Falls Prevention Network was established in The role of this network has grown since its inception and now includes: Meetings for discussion of falls related issues; Dissemination of research findings both local and international; Sharing resources developed and exploration of opportunities to combine resources in joint initiatives; Encouragement of collaborative projects and research; To act as a group to influence policy; To liaise with NSW Ministry of Health to provide information on current State/Commonwealth issues in relation to falls and Maintenance of resources pertinent to the field. The main purpose of the network is to share knowledge, expertise and resources on falls prevention for older people. The NSW Falls Prevention Network activities are part of the implementation of the NSW Falls Prevention Policy funded by the NSW Ministry of Health. Share your news and information/ideas Do you have any news on Falls Prevention you want to share with others on the network, or do you want to report on a project that is happening in your area. Please Esther with your information. We also welcome suggestions for articles and information you would like to see in this newsletter. Send your information to: fallsnetwork@neura.edu.au The Network Listserv It is great to see the increased activity on the listserv and we want to continue to promote this. To send an item to the listserv where all members of the network can see it, send an to: nsw-falls-network@lists.health.nsw.gov.au You need to be a subscriber to the listserv to send an that will be distributed to all members on the listserv. Remember to put a short description in the subject line. Falls Prevention is everyone s business For more information scan with your smartphone Recently some posts to the listserv have bounced due to address changes, you need to re-subscribe with your new address and unsubscribe from your old address following the Join the Network instructions as shown on this page. NSW Falls Prevention Network