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

Heaton, C 2019, Experiences of falls in domestic settings and use of ambulance services : an ethnographic study , DProf thesis, University of Salford.

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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 Local unpublished data from an English ambulance service found that following ambulance call-outs, 24-32% of the patients were not conveyed to hospital and of those, only 32-52%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.

Item Type: Thesis (DProf)
Schools: Schools > School of Health and Society
Depositing User: C Heaton
Date Deposited: 12 Feb 2020 13:49
Last Modified: 27 Aug 2021 21:32
URI: https://usir.salford.ac.uk/id/eprint/53439

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