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.
The objectives were to assess recruitment rate and feasibility of online survey delivery, and 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 and their role, with 5-point Likert scales of confidence.
Descriptive statistics and Chi-square analyses were used for quantitative data.
Results:
81 responses were received from across the regional ambulance service’s 16 localities.
76% of respondents were paramedics, and 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 appeared to be significant variation between confidence levels relating to utilisation of hospital pathways and localities (p-value=.0045).
Length of experience in both frontline ambulance and overall healthcare provision was not significantly associated with different levels of confidence.
Conclusion:
The overarching confidence of clinicians did not significantly vary around the region.
Locality of work had a relationship with confidence in utilising hospital avoidance pathways, however, did not relate to confidence in assessing this patient population.
Confidence was not found to increase for either total years providing healthcare, nor providing emergency frontline care.
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