References
Norms of staff responses to falls in residential care
Abstract
The aim of the current research was to review the first-line response to patient falls in the independent care sector in North East England. The authors used an online questionnaire via ‘Survey Monkey’ software package, and a convenience sample of 24 of 32 independent care sector homes from South Tyneside, representing a 75% response rate. Policies and guidelines for falls were investigated and the findings highlight the disparate responses to incidences in care-home settings. Despite 96% having a policy on falls, only 80% included an assessment of possible injury or harm and 13% included no direct guidance for staff when residents fall. The most common action was to ring emergency services to move patients, even in the absence of physical injury. There was considerable ambiguity around the assessment of injuries and whose responsibility this was, particularly in falls with potentially non-visible injuries. Ambiguity was also present in the management of falls, where there was overlap between accident and falls policies. The current research highlights the need for policy standardisation. There is a potential fiscal impact on emergency ambulance services when they are contacted as the first-line response for falls regardless of the occurrence of injury. This has implications on staff education and the strategic planning of emergency ambulance services. Further consideration on the suitability of falls policies is urgently required.
The disproportionate use of emergency ambulance services in relation to patient falls in the UK independent care sector is at an unprecedented level (Jennings and Matheson-Monnet, 2017; Pope et al, 2017). The existing literature demonstrates how the likelihood of inappropriate and frequent use of unnecessary ambulance services can be demographically predicted. Patterns are characterised by lower socioeconomic status, chronic disease status, and low perceptions of health-care accessibility in practice (Scapinello, 2016; Hudon et al, 2016). Notably, there is minimal mention of the accountability of independent care sector staff in requesting emergency services, nor of the relevant contexts, but which may both be attributed to people in these groups.
Raising awareness of the implications of the unnecessary use of emergency services is pivotal if it is to be prevented. If organisations recognise the fiscal expense and potential human cost of wasted time for paramedics, a mechanism of public education is warranted.
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