Experiences of falls in domestic settings and use of ambulance services : an ethnographic study

IntroductionEach year, 35% of people over the age of 65 experience falls andapproximately 45% of those are aged over 85 and live in the community. Localunpublished data from an English ambulance service found that followingambulance call-outs, 24-32% of the patients were not conveyed to hospital andof those, only 32-52% were referred to the local Falls Prevention Service for aspecialist multifactorial assessment (NICE, 2013).BackgroundThe literature review undertaken supports the need for a falls pathway(guidance for practitioners) to be in place which is fully utilised, by allpractitioners. However, it did not uncover the reasons for low referral rates ofnon-conveyed patients to Falls Prevention Services. This thesis will outline thedesign of a study which aims to, gain an in-depth understanding of the fallspatient journey from patient and ambulance crew perspectives and generate aclear understanding of the ambulance service customs and practices whichcould inform improvement of the existing falls pathway.MethodsA critical ethnographic approach enabled participants’ values, behaviours andbeliefs to be explored. The methods were participatory observation, semistructured interviews of patients/carers and ambulance crew and in-depth fieldnotes. The sample was people over 50 years of age who had fallen or theircarers (n= 10) who had been seen by the ambulance service. Ambulance crewwere also recruited (n= 10).ResultsThe study gained an in-depth understanding of the experiences of crew andpatients/ carers. For both ambulance crew and patients/carers, there are twoshared themes ‘falls journey’ & ‘falls not being a problem for patients’. For crew‘training’ was a theme and for patients/carers ‘language’ and ‘patient transport’are themes. The study’s unique contribution is that it has gained an in-depthunderstanding of the patient journey from patient and ambulance crews’perspectives and a better understanding of the falls pathway. In summary, thefalls pathway in the local area was clearly understood and followed by all crewobserved. The study shared the challenges of recruiting in a hard-to-reachgroup.

Level dc:type.qualificationlevel

Doctoral (Level 8)

Year dc:date.issued

2019

Author dc:creator

• Heaton, C

Language dc:language

en

Identifier

oai:salford-repository.worktribe.com:1362982

OAI identifier oai:identifier

oai:salford-repository.worktribe.com:1362982