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
Conclusion
The rate of falls in our patient population was lower than rates quoted in the literature.[3] This may be due to the availability of specialist nursing care for geriatric patients in the rehabilitation setting,
as well as more experience identifying high risk patients and taking appropriate precautions.
The rate of radiological work-up was lower in our patient group than that in similar reviews.[4] This may be due to the unavailability of imaging out-of-hours in this centre.
We found that patients reviewed medically for falls out-of-hours did not always have findings consistently and comprehensively documented in their medical notes.
Patients who had fallen out-of-hours were also less likely to undergo imaging than those who fell when on-site radiology was available.
We feel this may highlight the need for a post-fall work-up protocol,
which could include guidance on the need for imaging based on findings on examination and risk factors for serious injury,
and support clinicians in their decision to transfer patients externally for imaging.
These post-fall medical assessment proformas are being used more commonly both in Ireland and internationally to ensure a standardised model of care for patients who sustain falls in hospital.
As all patients who had sustained falls had at least two risk factors for falls,
we feel this reinforces the importance of identifying high-risk patients and ensuring adequate falls-prevention measures are put in place.[5]
Despite best practice in prevention strategies,
falls are an almost inevitable occurrence in the inpatient setting.
Our audit has identified the importance of ensuring standardised post-fall care and the importance of carrying out radiological work-up when indicated.