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

Heaton, C

Abstract

Introduction
Each year, 35% of people over the age of 65 experience falls and
approximately 45% of those are aged over 85 and live in the community. Local
unpublished data from an English ambulance service found that following
ambulance call-outs, 24-32% of the patients were not conveyed to hospital and
of those, only 32-52% were referred to the local Falls Prevention Service for a
specialist multifactorial assessment (NICE, 2013).
Background
The literature review undertaken supports the need for a falls pathway
(guidance for practitioners) to be in place which is fully utilised, by all
practitioners. However, it did not uncover the reasons for low referral rates of
non-conveyed patients to Falls Prevention Services. This thesis will outline the
design of a study which aims to, gain an in-depth understanding of the falls
patient journey from patient and ambulance crew perspectives and generate a
clear understanding of the ambulance service customs and practices which
could inform improvement of the existing falls pathway.
Methods
A critical ethnographic approach enabled participants’ values, behaviours and
beliefs to be explored. The methods were participatory observation, semistructured interviews of patients/carers and ambulance crew and in-depth field
notes. The sample was people over 50 years of age who had fallen or their
carers (n= 10) who had been seen by the ambulance service. Ambulance crew
were also recruited (n= 10).
Results
The study gained an in-depth understanding of the experiences of crew and
patients/ carers. For both ambulance crew and patients/carers, there are two
shared 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-depth
understanding of the patient journey from patient and ambulance crews’
perspectives and a better understanding of the falls pathway. In summary, the
falls pathway in the local area was clearly understood and followed by all crew
observed. The study shared the challenges of recruiting in a hard-to-reach
group.

Citation

Heaton, C. Experiences of falls in domestic settings and use of ambulance services : an ethnographic study. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Feb 12, 2020
• Publicly Available Date: Feb 12, 2020
• Award Date: Jan 1, 2019