You may have recently read in the media recommendations from a coroner’s report regarding the death of a man in the Taranaki Emergency Department.

While these recommendations apply to the Emergency Department setting, now is a good time for urgent care to remember our role in preventing falls, particularly in the elderly.

The risk of falling increases with age, with a third of people over 65 falling each year, many resulting in injury. 1 It is, therefore, very important to consider the risk of falls in all older people, regardless of whether a fall was the reason for their presentation to urgent care.

The coroner’s report has suggested falls assessments in ED happen at triage, or at the time of the primary assessment. In urgent care, the triage process is to ensure that the sickest and most in need patients are seen first, and it is not the time to be doing more in-depth assessment, including falls risks. If a triage nurse has concerns, then they should flag these in their triage notes, but a falls assessment should take place by the clinician attending to the patient prior to discharge, if clinically appropriate. If a falls risk has been identified, and the patient is being admitted, then this information should be flagged on the admission letter. If a falls risk is identified in a patient being discharged, then thorough safety netting needs to be in place with close follow-up with the patient’s usual GP as soon as able.

To help in considering and assessing falls risk in older people, there are several resources that you are recommended to review

Engagement with these activities can be claimed as CPD. Enter your learnings and reflections in UCCIS.

Reference

  1. Osteoporosis NZ – Frequent Fallers