IMPACTS OF AN ETHNOGRAPHIC STUDY OF EXPERIENCES OF FALLS IN DOMESTIC SETTINGS AND THE USE OF AMBULANCE SERVICES

Objectives: The study aimed to gain an in-depth understanding of the patients’ journey following a fall, from patients and ambulance crew perspectives.

Methods: A critical ethnographic approach enabled participants’ values, behaviours and beliefs to be explored. The methods were participatory observation, semi-structured interviews, and in-depth field notes. The findings were thematically analysed, and narrative used to add meaning to their experience.

Results: The study gained an in-depth understanding of the experiences of crew and patients. For both ambulance crew and patients, there were two shared themes ‘falls journey’ & ‘falls not being acknowledged as a problem for patients. For crew ‘training’ was a theme.

Discussion: The study shared the challenges of recruiting in an underserved population.

Impacts from practice recommendations:

Raise public awareness and understanding of falls risk

The findings and knowledge generated from this study have influenced and contributed to the change of policy and practice. This has also had a cultural and social impact in supporting the development of a borough wide Strategy for the Prevention and Management of Falls and Bone Health, which aims to provide timely, coordinated, effective evidenced based assessment and interventions.

Provide crew falls training

The local falls pathway was established in 2011, audit findings in 2015 found 42% of patients seen following a fall were referred to the falls services. All local crew were provided training following the study in 2020 with positive feedback received. A reaudit later in 2020 found 84% of patients seen were referred.

Key words: Falls prevention, ambulance, patients & crew perspective, Bone Health