A key priority in our NMAHPs strategy is to develop leadership capacity, capability and resilience creating a culture of innovation to improve clinical outcomes in a supportive environment.
We do this in Newcastle by encouraging and empowering our nursing, midwifery and allied health professional leaders to influence and shape high quality care
The Community Response and Rehabilitation Team (CRRT) work collaboratively with colleagues at Newcastle City Council to help people who live in the Newcastle area or who have a Newcastle GP.
The community-based team of health and social care professionals provide treatment, rehabilitation and support to help people remain independent in their own home for as long as possible.
Nurse Specialist Alpha Toledo joined the team in April 2020 and although she recognised that the team had been providing a high-quality holistic assessment, she felt that more could be done to help keep patients safe at home, in particular in preventing patients falling.
She observed that lying and standing blood pressure was not a standard assessment carried out by the team for patients who are at high risk of falls, however this was standard practice for patients admitted to hospital.
During the Covid-19 pandemic, it was noted that there were a high number of patient referrals due to falls and the team witnessed the consequences of deconditioning and inactivity to the elderly and frail.
Remote and teleconsultations were necessary but most of the factors that increase the risk of falls like mobility, balance, home environmental hazards, functional ability, and blood pressure were impossible to fully assess over the phone.
CRRT was one of the community teams who during the pandemic was still able to visit patients at home and this was an ideal opportunity to carry out a holistic comprehensive assessment, including assessing the home environment, footwear, eyesight, mobility, balance, and taking lying and standing blood pressures to check for orthostatic hypotension.
It quickly became apparent that checking patients for orthostatic hypotension was as equally important as assessing mobility and home environment.
Although this had not been a routine test conducted by all members of CRRT previously, it was agreed that this should be included as a standard measure in helping to identify patients at risk of a fall.
