Abstract
Introduction: The number one reason for older people to be taken to hospital emergency departments is a fall1. An “Ambulance Improvement Programme Pillar”2 is trying to reduce conveyance to hospital for falls, however it is not understood how the attending clinician’s confidence impacts decision-making.
Objectives:
1. Assess recruitment rate.
2. Assess feasibility of online survey delivery.
3. Determine the experiences and confidence of frontline emergency clinicians in attending older adults who have fallen.
Method:
Online cross-sectional survey, undertaken in one English ambulance service in May 2023.
Demographics were collected from participants about their role, along with 5-point Likert scales of confidence.
Data were summarised using descriptive statistics and Chi-square analyses to compare confidence between localities and years’ experience.
Results:
81 responses were received from across the regional ambulance service’s 16 localities.
76% of respondents were paramedics, other respondents were emergency medical technicians and student paramedics.
53% were aged 25-34.
60% of respondents rated being ‘somewhat confident’ to ‘How confident do you feel in assessing older adults who have fallen?’, responses ranged between ‘Neither confident nor unconfident’ to ‘Completely confident’.
No significant difference was found between the locality and confidence levels for assessing this patient population. However, there was a significant difference between confidence levels when utilising hospital avoidance pathways across localities (p-value=.0045).
Length of experience in either frontline ambulance and overall healthcare provision was not significantly associated with different levels of confidence.
Conclusion: Locality of work had a relationship with confidence in utilising hospital avoidance pathways. In contrast, locality of work did not significantly impact confidence to assess older adults who have fallen. Confidence levels were not found to be related to the number of years providing healthcare. Online survey delivery is feasible effective method in this population.
References
1. Dewhirst. (2023). National Falls Prevention Coordination Group. https://committees.parliament.uk/writtenevidence/117837/pdf/
2. NHS England and NHS Improvement. (2019). Ambulance Improvement Programme. https://www.england.nhs.uk/wp-content/uploads/2019/09/planning-to-safetly-reduce-avoidable-conveyance-v4.0.pdf