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Editorial Board</text>
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Evaluation of an emergency department falls pathway for older people: A patient chart review&#13;
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                <text>The number of older adults presenting to EDs following a fall continues to rise, yet falls management often ignores opportunities for secondary falls risk reduction. Advanced Nurse Practitioners (ANPs) in EDs have an important clinical leadership role in improving outcomes for this group of patients. &#13;
Aim: This study describes the development of an ANP led falls pathway in an ED to improve safe discharge. It evaluates compliance with the pathway and referrals to community falls prevention services. It also draws comparison with baseline practice as recorded in 2014.&#13;
Methods: The Falls Pathway involves four steps: 1) screening at triage (3 questions), 2) risk stratification (low, medium, high), 3) risk assessment (lying and standing blood pressure (B/P), timed-up and go (TUG), 4-AT for delirium screening, polypharmacy), and 4) referral to community falls services. We undertook a 12-month chart review of all patients aged 65 years or older presenting following a fall to the ANP service in 2018. We compared data to a baseline audit in 2014; descriptive and Chi squared statistics were used to examine the data.&#13;
Results: The 2018 audit involved 77 patients representing 27% of ANP caseload. A repeat fall occurred in 42% (32/77) of cases and 35% (22/77) reported a fear of falling. The Falls Pathway was initiated in nearly 80% (62/77) of patients and compliance with falls risk assessment ranged from 42% for lying and standing B/P to 75% for TUG. In 2014, a review of 59 patient charts showed 27% (16/59) experienced a repeat fall, but other risk factors such as fear of falling were not recorded. In 2018, the majority of patients (88%) discharged home were referred to community falls prevention services compared to 22% in 2014.&#13;
Conclusion: The Falls Pathway improved falls risk assessment in the ED, identified opportunities for risk reduction and optimised referral to community falls services. The pathway continues to be a valuable tool but requires resources for ongoing implementation among the wider ED team. </text>
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                <text>International Emergency Nursing Vol. 51 July 2020&#13;
Reflecting on the challenges of sustaining emergency care research during the Covid-19 pandemic (Editorial)</text>
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                <text>As many parts of the world start to establish a ‘new normal’ during the Covid-19 pandemic, it is important for all to take time to reflect on what has happened and what the future holds in store for both academic and clinical emergency care. Although for many the focus has been on the fast-evolving pace that healthcare has been forced to adapt to meet the needs of the population, research practice in this area has been required to adapt at a similar speed. Although there have been many exemplifiers of excellent research work undertaken and disseminated throughout the pandemic, it has been a challenging time at the research interface. This has been particularly true for both researchers focused on non-Covid-19 research and research active clinical staff who have redeployed their time to clinical practice. It is important to acknowledge these challenges and consider how these affect the quality and production of new knowledge in a post pandemic world. There is no doubt that Covid-19 has impacted on global research, but these reflections are based on the current challenges that are ongoing currently in the UK. </text>
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                <text>Edward Baker, Geraldine Lee</text>
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