“Just ring for an ambulance?" Local survey reveals the behavioural norms of staff from organisations responding to patient falls in the independent residential care sector

Scott-Thomas, Jeanette, Graham, Yitka, Ling, Jonathan, Barrigan, Marie and Hayes, Catherine (2018) “Just ring for an ambulance?" Local survey reveals the behavioural norms of staff from organisations responding to patient falls in the independent residential care sector. Journal of Paramedic Practice . Item availability may be restricted.

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Abstract

Aim: To review the first line response to patient falls that is operational in the independent care sector in a specific geographical region of North East England.

Design: Questionnaire survey implemented online via ‘Survey Monkey’ software package.

Sample: A convenience sample of 24 of 32 independent care sector homes from South Tyneside, UK participated in the study, representing a 75% response rate.

Results: Policies and guidelines for falls in the independent care sector homes were investigated, as understood by care home managers. The findings highlight the disparate responses to falls in the care home settings. Despite 96% of homes having a policy on falls, only 80% of these included an assessment of possible injury or harm to residents and 13% included no direct guidance for care staff in instances where residents fall and are on the floor. For those policies that did include direct guidance, there was a great disparity in available information, especially between domiciliary and residential care home settings. The most common recommended action was to ring emergency services in order to move patients, even in the absence of evidence of physical injury. In the context of residential care home settings there was a high degree of ambiguity around the assessment of sustained injuries and whose responsibility this was. This was particularly evident in relation to falls where potentially non-visible injuries which were subsequently not immediately identifiable. There was also reported ambiguity in relation to the management of falls, where there was overlap between accident policies and falls policies.

Conclusions: Our research highlights the need for standardisation of policies and procedures in relation to falls of those living under the care of the independent care sector. At present, there is a disparate set of approaches evident in the contexts of care, which are largely determined by locally devised and implemented policies, which prioritise legalistic and bureaucratic concerns over clinical decision making. Our study highlights the potential fiscal impact on emergency ambulance services in instances where it is commonplace for contacting emergency services to be the first line response to a patient falling to the floor regardless of whether an injury has occurred. This has important implications for the education of independent care sector workers and the strategic planning of emergency ambulance services. Whilst generic frameworks are available, further consideration of the whether falls policies are suited for purpose is urgently required.

Item Type: Article
Journal or Publication Title: Journal of Paramedic Practice
Publisher: Mark Allen Healthcare
ISSN: 2041-9457
Departments: Services > External Relations
Additional Information: Dr Catherine Hayes is Visiting Professor of Higher Education at the University of Cumbria, UK. (Article in press.)
Depositing User: Anna Lupton
Date Deposited: 08 Mar 2018 12:58
Last Modified: 19 May 2018 15:27
URI: http://insight.cumbria.ac.uk/id/eprint/3657

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