Nursing Innovations

Bone Health in the Park

A major challenge facing all individuals working with older adults is falls and falls related injuries (ref). Studies on falls in the older adult are indicating that they are increasingly becoming a problem locally, nationally and internationally (ref).  . The impact of falls can be exacerbated by the presence of osteoporosis. The National Strategy to “Prevent Falls and Fractures in Ireland’s Ageing Population” (2008) calls for falls prevention to be a priority for all service providers.


An audit of the St Mary’s Healthy Ageing Clinic in 2008 identified that two thirds of attendees had reduced bone density with almost half receiving a diagnosis of osteoporosis. With our ageing population nationally this problem is set to grow with plenty of projections of what costs will be in the future with little evidence around investment into trying to reduce the cost through preventative measures. As an Advanced Nurse Practitioner working with older adults it became evident there was a clear requirement for interventions in this area of practice to offset some of those costs both financial and in relation to the cost to quality of life.


In acknowledgement of this a proactive approach was taken in St Mary’s through the innovative development of Bone Health in the Park which as an initiative comprised of two phases.

Phase 1 - eBoneHealth focuses on the importance and relevance of bone health for all ages and has been purposefully designed for all staff groups, families, friends, patients, residents and visitors.

Phase 2 – Forever Autumn is a falls awareness and falls prevention programme for all staff - clinical and non clinical and is a campus wide initiative with multidisciplinary involvement which included:


  • A review of the Falls Prevention and Management Policy

  • Introduction of a new Falls Risk Assessment Tool

  • Introduction of new Falls Risk Symbols

  • Introduction of Falls Reduction Measures

  • Development of an Education Resource for staff on all of the above


Through the development of the education resource for our staff it is envisaged the new measures being introduced to reduce the risk of falls to our patients and residents can be successfully implemented.


Using education technology a suite of differing teaching and learning resources were created using software that could be accessed from differing platforms, as it is envisaged that the formal eLearning programme will be shared with other healthcare service providers. To widen our commitment to open and shared learning other healthcare professionals and members of the public may  view the Bone Health in the Park web site and download information resources from both projects from



Both programmes have been successfully implemented in St Mary’s. As a result there is an increased awareness by staff on their own bone health and that of the patients and residents they care for which is evident in the increased activity in the Healthy Ageing Clinic. Forever Autumn was launched in November 2012 and through the development of the education resource it is envisaged the new measures being introduced will reduce the risk of falls.

Our website is accessed by other health care professionals and the general public on a regular basis demonstrating a continued interest in new knowledge in bone health and falls prevention.


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Members of the ISHCA Project Team

ISHCA (Implementing and Supporting Holistic Continence Awareness) is a new initiative set up in St. Mary’s Campus by interdisciplinary staff who recognise that the promotion of continence in the older adult can have a huge impact on the quality of life of an older adult.. It is imperative that older persons with issues with continence are given every opportunity to regain full continence and at the very least have  incontinence managed in a way that promotes the dignity of the person.


Research has highlighted the need for increased education in all areas relating to the effective management of incontinence. The ISHCA education programme was developed to meet that need


Aims of ISHCA


  • To provide an easy to navigate  e-learning resource which facilitates healthcare staff to learn at their own pace at a time convenient to them, thus accommodating

different types of learning styles and abilities.


  • To equip staff with expert knowledge on key aspects of continence promotion in the older adult


  • To create a new culture of continence care that  will support practitioners across all settings to actively promote continence




  • To see an improved approach in the management of older adults with continence issues within the campus


  • To provide a 12 week period where staff can access easy to understand online education


  • To promote a person-centred approach to continence management leading to individualised assessments being carried out on all patients and residents. 


  • To see a reduction in the use of incontinence containment products and appropriate use of products following accurate assessments.


More information will soon be available on this project - if you would like more information please email Fiona Dunne