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Being the Manager of a facility who does not have a clinical background, I have found Gillian to be of huge support. She has a great understanding of the Aged Residential Care industry and is a wealth of knowledge. She has been nothing but supportive since we introduced her (the HCSL) policies and procedures into the facility in 2012.  Having her expertise on hand has been hugely beneficial for the Village.

Gillian also visits the facility twice a year providing education sessions which are both informative and engaging.  Staff have commented positively on her ability to share real life experiences during these sessions which show her true passion for what she does and the service we are here to provide.

Gillian is respected by staff, management and Governance of Springlands Lifestyle Village and I would have no hesitation in recommending her to anyone who is looking for a healthcare consultant who is knowledgeable, understanding and professional. She is committed to helping you improve the service you provide to your Residents.

Naomi Nailer

Village Manager

Springlands Lifestyle Village

Blenheim

January 2017

Is a slip off a chair or off the side of the bed onto the floor a fall?  Is a ‘controlled lowering’ by a staff member of a resident to the floor a fall?

When recording adverse events such as falls, it’s important for the purposes of consistent reporting and bench-marking that the same definition is used to define a ‘fall’.  We suggest using the definition provided by the World Health Organisation (WHO) which states “A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.”  The WHO falls prevention guidelines also report that “Globally, falls are a major public health problem. An estimated 424 000 fatal falls occur each year, making it the second leading cause of unintentional injury death, after road traffic injuries.”  

Working in aged care related services means you are interacting on a daily basis with those in the high risk category for falls. WHO also report for example, in the United States of America, 20–30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. The Health Quality and Safety Commission New Zealand report “for every fall in hospital, there are five in aged residential care and another 40 at home and in the community. Between 2010 and 2012, a total of 200 people fell while in hospital care and broke their hips.“

The HCSL QA online bench-marking includes tracking of falls and falls related injuries so educating your staff to become familiar with the definition is important in ensuring data collected is accurate. Accurate data measurements also allow you to be aware of your start point for quality improvement projects which can then be measured at the end of a project to measure the degree of improvement.

In answer to the questions posed at the start of this article, if we apply the WHO definition, then both should be classified as falls.  For those of you using the HCSL policy and procedure system, refer to the Falls Prevention Programme (document CS19) for more information on falls prevention.

‘Pressure injury’ according to ACC can be classified in some instances as a ‘treatment related injury’ and therefore you may have the option of gaining support / assistance from ACC in relation to treatment of the pressure injury. In their 2011 fact-sheet, ACC noted “Pressure areas are a significant source of treatment injury claims and impact on both patient morbidity and mortality (1). Between July 2005 and March 2011, ACC accepted 506 claims for pressure areas, and notified 45 as adverse events to the Ministry of Health”.

As pressure injuries are a key focus for Ministry of Health (MoH) this year, auditors will be looking closely at the documentation around identification, management, treatment / care planning and evaluation of these events. Ensure you have comprehensive evidence of your clinical management processes.

Also remember when you log a pressure injury into the adverse event reporting system, you include the stage of the pressure injury. In the HCSL QA online system click ‘pressure injury’ in the ‘type of event’ box and then in the box directly under that, you can record the additional detail of the stage of the pressure injury.

The required MoH notification forms can be found here.  You will need the resident GP to complete a ACC45 form. Then contact ACC and rather than asking for what you want, ask what they can do to help. If you ask first, you may be missing out on something they could have provided access to.

For more information on seeking support contact Assistant ACC directly or the ACC Contracts Manager – CDHB Email: Leanne.davie@cdhb.health.nz

After well over 20 years, I’m retiring and moving on to new ventures.  I just wanted to say a huge thank you for being there when I needed you and being a close colleague and work support. Your systems kept us on track meaning audit was always so much less stressful than it used to be. It does mean a lot to me to know you’re there at the end of the phone.

Thank you

your friend

Trudy Doreen Stevens (Owner – Shoshannim Care of the Elderly (Ohoka, Canterbury)