Transcript Document
Coventry Physiotherapy Falls Service 02476 237 051 2013 Aims of the Coventry Physiotherapy Falls Service • Provide a single point of access for patients, carers and health professionals • Provide timely physiotherapy intervention to assess for and reduce the risk of falls • Provide advice and education to patients, carers and health professionals Falls Guidelines NICE Guidelines CG161 Falls: The Assessment and Prevention of Falls in Older People (June 2013) • Patient Centred Care • Case/risk identification • Multifactorial falls risk assessment • Multifactorial interventions • Strength and balance training • Education and Information giving • Environmental Adaptations • Professional education Criteria to attend • • • • • • • • At risk of falling/ previous falls Over 65 years of age – 91% 70yrs + Fully weight bearing Able to understand/comply Balance/physical cause of falls Motivated to participate Cardiovascular stability Able to attend Newfield House Access • GP’s ~ 30% Refer for non medical intervention by Physiotherapy • UHCW ~ 30% Dr Chaudhry – Falls Clinic (10%) Emergency Department/REACT Therapists on wards Integrated discharge teams • CWPT ~ 30% Locality therapists/Fast Response/Community Matron/District Nurses Coventry Musculoskeletal Service/Podiatry Community Physio CMHT • Other ~ 10% Assessment • • • Multi-factorial assessment Poly pharmacy Osteoporotic risk Cognition Functional ability Footwear Continence Vision Assessment of home hazards Hearing Physiotherapy assessment; • Falls History – mechanical, medical, environmental, unexplained • Past medical history and medication • Balance – Validated Outcome Measures; TGUG, Berg Balance, Short FES-I, EMS. • Muscle Strength, ROM, gait analysis, gait aids, pain, ADL’s. Person centred goals – Goal Attainment Scale – Quality Goal Referral to other services Assessment • Environmental assessment questionnaire; – Completed by patient/carer prior to attending for assessment – Onward referral onto • Pathway locality Occ. Therapy • OPAL – Environmental Adaptations • Coventry Integrated Equipment services Treatment • Provided with individualised Otago exercise booklet – Expected to perform exercises 3-4 x week at home • Patients attend weekly – Newfield House for a 7 week programme • Review week 7 – – – – – – Group session - Individual exercise plans Supervised by physiotherapist and assistant Strengthening and balance exercises Backward chaining Education sessions provided Discharge Planning Review • Patients receive telephone follow-up after 6 months of discharge from service • Review short FES-I • Planning • Patients can contact during this period if having problems/further falls Physical outcome measures July 2013 improved, on average by 20-30% Outcomes Patient Satisfaction • 100% strongly agree/agree that they were involved with goal planning • 100% strongly agree that they would recommend the service to friends and family “My treatment and care was excellent and most helpful as the lessons progressed I became much more confident and sure of myself and my ability to do the exercises.” “The falls classes …gave me reassurance and confidence to go out alone and took away the vulnerability when going out alone..” • 0% in re-attendance at Accident and Emergency due to a mechanical fall • 20 % return to reassessment • 10 % attend classes again Contact Details • Clare Mee – Community Physiotherapy and Community Neuro Rehab Team Lead – 0300 2000 396 • Claire Murphy – Physiotherapist [email protected] • Hannah Wade – Physiotherapist [email protected] • Donna Barnes – Assistant Practitioner [email protected]