Keywords:
Bones, Trauma, Spleen, Conventional radiography, CT, Outcomes analysis, Health policy and practice, Audit and standards, Quality assurance, Geriatrics
Authors:
C. McDonnell1, S. Forman2; 1Co Dublin/IE, 2Dublin/IE
DOI:
10.1594/ecr2018/C-2035
Aims and objectives
Inpatient falls in hospital can lead to significant morbidity and generally require a medical review and often radiological work-up if an underlying injury is suspected.
This can naturally lead to increased pressure on healthcare institutions and increase costs of inpatient admission.[1]
As a group,
the elderly are particularly prone to falls in the healthcare setting,
and the adverse effects of falls are often more pronounced in this population.[2] The rate of falls in elderly inpatients of hospitals can be as high as 2.5 falls per patient in one year.[3] Radiological work-up is often essential as up to 30% of falls result in injury,
and 4-6% resulting in serious injury such as fractures and intracranial haemorrhage.[4]
This audit,
carried out in a rehabilitation hospital with no out-of-hours radiography service,
evaluated the care received by all patients who had sustained falls within a 5-month period.
In particular,
we wanted to evaluate factors which led to the decision to carry out,
or forego,
imaging out-of-hours.
Any imaging carried out out-of-hours,
and any imaging more advanced than plain radiography required during normal working hours,
would require transfer to a tertiary centre. In essence,
we wished to compare the management of those who sustained falls during the working day with those who fell out-of-hours,
and in doing so,
ensure that an appropriate standard of care was maintained,
regardless of the time of day or night.