1. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. The Relationship Between Infections and Falls Anita Walkinshaw Falls prevention Co-ordinator Suffolk Community Healthcare May 2010

2. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Session Overview Significance of falls - overview Urinary tract infection & falls Referral process into Local Healthcare Teams Falls and bone health training in care homes

3. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust.

4. Cost of a Hip Fracture One fractured NOF costs - £12,000 (NOS 2001) Nationally fractured NOF’s cost the UK £1.8 billion/year –45% for acute care, –50% for social care and long term care –5% for drugs and follow-up care (NOS 2001)

5. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Falls in care homes are costly 3 times more likely to fall 25% suffer serious injuries 40% of admission from care homes Litigation suggest a breach of duty of care Complaints create negative publicity Emergency action from staff diverts staff from planned care Care to relieve injuries and anxieties from a fall increases workloads

6. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Significance of falls in care homes > 50% of all falls occur while residents are: – trying to get to/return from the toilet or exit the bed to get to the toilet (Hendrich 2006)

7. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Urinary Tract Infection and falls Increased incidence in care setting Increased incidence in the elderly – age Women –20% increase age 65 – 70 –20-50% increase in age 80 Men –3% increase age 65 – 70 –20-50% increase in age 80 Grey & Malone-Lee 1995

8. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Urinary Tract Infections cont Recurrent UTI common in elderly than younger people Dehydration 10-15% in care homes (catheter) Hosam et al, 2005 Poor personal hygiene Other infections – e.g. chest infections

9. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Signs & Symptoms Confusion/worsening mental function/distress Change in appetite/loss of appetite Decrease in fluid intake Functional decline Pain lower back, abdomen, sides Frequency/urgency Mobility – rushing to get to toilet Immobility Bladder/kidney infections – fever, chills, nausea, vomiting, etc

10. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. UTI Prevention & Management Regular toileting of high risk residents Encourage fluid intake Cotton undergarments Attention to personal hygiene Medical assessment and treatment

11. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Local Healthcare Teams Overview Single Point of Access Based in localities Physio assessment, Urgent OT assessment, rehabilitation, urgent nursing need if appropriate Waveney: –Admission Prevention Team

12. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Falls & Bone Health Training Falls & bone health risk factors, prevention, management & referral processes Assistive technology Sign posting to other service providers Falls champions

13. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Summary Prevent UTI and other infections Crucial to identify early and take appropriate interventions In-depth falls and bone health training is currently offered

14. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Falls Prevention Co-ordinators Contact Details East Anita Walkinshaw, Tel: 01473 275250 Email: anita.walkinshaw@suffolkpct.nhs.ukanita.walkinshaw@suffolkpct.nhs.uk West Ann Hunt, Tel:01284 748824 Email: ann.hunt@suffolkpct.nhs.ukann.hunt@suffolkpct.nhs.uk Waveney: Andrea Sargeant, Tel: 01502 535122 Email: andrea.sargeant@nhs.net

15. Suffolk Community Healthcare is responsible for providing NHS services in the Suffolk area and is hosted by Suffolk Primary Care Trust. Thank you for listening Any Questions