1. ABMU East Area (Bridgend)

2.  A+E audit by 2 doctors in 2008 identified that falls were poorly managed in A+E  Patients were rarely referred for further investigation and prevention  Falls project Dec2008-April2009,A+E pilot study for 1 week TotalAverage per day Total attendances 1251178.7 65>15422 No. of fallers365.1

3.  Followed up by telephone and home visit, if required  Telephone assessment effective at indentifying those who needed further investigations  Despite low numbers would be considerable amount of workload for one individual  Basic screening in A+E would be more effective

4.  Patients 65> presenting at A+E not always being asked if their injury is the result of a falls  Community Integrated Intermediate Care(CIIS) Senior Nurse based in A+E trialed falls risk screening tools  To identify a screening tool that was quick and easy to complete but gave meaningful information e.g Elderly Falls Screening Test(EFST)  Nurse in A+E delegated responsibility for looking at consequences of falls/falls prevention in A+E

6.  Met with relevant personnel in A+E  Decision made by Nurse that the screening tool be completed during the triage process  Pilot would run for a period of 4 weeks  Every patient 65> presenting at A+E would be asked if their injury was as a result of a fall  Following intervention the bottom section of the form would be completed by designated nurse

7.  21 patients screened- could have been 4times as many  Female-76% 80>  Male- 23% 80>  Risk factors identified:-  Medical problems- 95%  Balance and Strength- 85%  Staying active- 71%  Fear of falling- 61%  What to do if they fell- 38%  Managing at home/hazards- 61%  Vision- 61%  Nutrition- 33%  Feet and footwear- 23%

9.  Feedback from staff in A+E  The screening tool fulfilled the requirements of being quick, easy and meaningful  From their experiences we have developed the form further i.e after each question there are signposting suggestions for positive answers  Continue to work with colleagues in A+E  Aim – ensure that all patients 65> are routinely asked if their injury is as a result of a fall

10.  Now using an adapted version of the screening tool for Public Health ‘Falls Prevention’ campaign in the Bridgend area  2 GP surgeries  Linked to flu vaccine clinics  2 levels of screening  Falls Resource Pack

11. Any Questions???