This assignment will focus on the issue of Risk Assessment with
relation to falls in the home in the elderly population. It will
discuss the relationship between the community healthcare team and the
individual client, the government policies related to the topic, and
the influences of health policy upon the provision of community care.
The role of the community nurse in public health education and
promotion will also be explored.
The client, in this particular instance, is Mrs Pugh. She is an
84-year-old female who lives alone since her husband's death 3 years
ago. Mrs Pugh has a previous medical history of 'unexplained falls'.
Her medical ...view middle of the document...
Last (1994) describes epidemiology as
'completing the clinical picture'.
Research has a much higher profile in Health Authorities and Health
Organisations today. Policy and service provision is expected to be
based on research and practitioners are encouraged to base their
practice on evidence. The Department of Health (DoH) has insisted on
reliable research, which evaluates practice and procedures as well as
the knowledge gained from individual professional experiences (DoH
1993). Funding for health promotion research may come from Health
Authorities or a Health Education Authority. A shift towards
consumerism and accountability in the National Health Service (NHS)
has increased interest in qualitative research, which gives people a
voice (Naidoo and Wills 1999). The principles of the World Health
Organisation (WHO) Health For All Strategy (WHO 1985) accept that
health is a relative concept and illness must be taken into account
when trying to promote health. The WHO defines health promotion as
enabling people to increase control over their health and factors
influencing their health.
The educational model of health promotion seeks to provide advice and
information to enable informed decisions. Tones and Tilford (1994)
state 'the quality of the planning process is the best predictor for
effectiveness'. This can be assessed using the following criteria:
relevance, individualisation, feedback, reinforcement and
Delivering health promotion within Primary Healthcare (PHC) has many
advantages. The Primary Healthcare Team (PHCT) has access to the whole
population. 97% of the population is registered with General
Practitioner (GP) and over 70% of patients consult their GP at least
once per year (Office of Health Economics 1994). Doctors and nurses
are seen as highly credible sources of information and advice on
health. PHC practitioners already work in teams, the core team of GP,
practice nurse, practice manager are often complimented by a broader
team which would include community-based nurses, specialist nurse
practitioners, occupational therapists (OT), dieticians, speech and
language therapists (SALT), physiotherapists and welfare workers such
as health visitors and social workers. The PHCT provide continuity of
service together with easy access, which is highly valued by clients.
As the NHS is encouraged more towards evidence-based practice,
supporters of health promotion claim health promotion in PHC is an
effective use of resources, using recent studies to support their
claim (MacPherson 1994, Doyle and Thomas 1996). The 1999 public health
white paper included recognition that 'new major Government policies
should be assessed for their impact on health ' (DoH 1999).
Accidents are the commonest cause of death among people under 30 years
in England and...