TE PUAWAI
The campaign identifies tools, interventions, networks, collaborations, promotions, resources and workforce development opportunities that will make it easier for health sector workers to keep people safe. Future focus areas for the campaign are reducing harm from surgery, healthcare associated infections, and medication.
A series of videos about falls – in hospital, at home, in the community and in aged residential care – has been developed for the campaign. These videos can be viewed on the campaign website: www. open. hqsc. govt. nz, or by emailing the Commission’ s campaign team on open @ hqsc. govt. nz for a free DVD containing the suite of videos.
Preventing falls in older people
It’ s generally accepted that the likelihood of falling for older adults increases with age. However, we need to consider wide variations in older people’ s fitness and frailty, and the interaction between individual risk factors and a person’ s environment to respond appropriately to the challenge of preventing falls and reducing harm from falls in older people.
In general, for healthy community-dwelling people aged 65 years and over, around 30 percent will fall at least once each year, mostly without serious injury, but about 5 percent will have a fracture or require hospitalisation related to a fall.
However, increasing age is related to a near doubling in fall rates and fall-related injuries in community-dwelling people aged 75 years and over. Older people living in age-related residential care have higher rates of falling and more serious fall-related injuries, with 10-25 percent of falls resulting in fracture or laceration.
Patient falls that result in harm are the most frequently reported adverse event in hospitals. Of the 730 serious and sentinel events reported by DHBs in the two years 2010 – 12, 365 were patient falls, and of these 170 were associated with a hip fracture. 1 It is estimated that 22 more people died than we would otherwise expect.
Older people may take longer to recover from fall-related injuries, or develop a fear of falling – both of which can mean that inactivity and loss of condition increases their risk of falling again. Critically, older people may develop a fear of falling, which sets off a downward spiral. 2
National programme- reducing harm from falls
The Commission is leading a national programme to reduce harm from falls, working in partnership with the Accident Compensation Corporation( ACC) and other stakeholders across the health sector.
The programme’ s purpose is to reduce harm from falls by supporting interventions which prevent falls and reduce fall-related injuries. The priority is older people at risk, defined as those aged 75 +( Māori / Pacifika aged 55 +) in care settings( ie, hospital inpatients, people in aged residential care, and those at home receiving care), and those with polypharmacy or previous hip fracture.
1 Health Quality & Safety Commission. 2013. Making our hospitals safer – Serious and Sentinel Events 2011 / 2012. Wellington: Health Quality & Safety Commission. 2 Rubenstein LZ. 2006. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and ageing, 35( suppl 2), ii37-ii41.
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