2004 How confident are we in decision making? The quantitative analysis of ambulance response to older adult fallers: A pilot survey

Abstract

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. Items included participant demographics and 5-point Likert scales of confidence. Data were summarised using descriptive statistics and Chi-square analyses to compare confidence between localities and years’ experience. Results 81 responses were received from across the regional ambulance service’s 16 localities, supporting online survey delivery to be feasible in this population. 76% of respondents were paramedics, and 53% were aged 25-34. 60% of respondents rated being ‘Somewhat confident’ in assessing older adults who have fallen, with responses ranging 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 Online survey delivery is an effective method in this population. Locality of work had a relationship with confidence in utilising hospital avoidance pathways, however, it did not relate to assessing this population. Confidence levels were not found to be related to the number of years providing care.