Abstract
Are teams appropriately scanning patients who they know/suspect have sustained a head injury following an inpatient fall? This study examined the appropriateness of neuroimaging requests over 6 months on a geriatric ward at the Freeman Hospital, Newcastle-upon-Tyne. The study also examined whether scans were performed and reports made available within the NICE-stipulated time frames, and also looked at the falls review documentation, and the rationales for neuroimaging (including the role of anticoagulation).
DATIX records of all inpatient falls from March-August 2022 were acquired, and the fall reviews analysed for compliance with local/NICE guidelines. 56 patients were identified after exclusions.
81% of patients who met one or more criteria for a CT head scan were scanned. All patients were scanned within the 8-hour time frame, however only 50% of the patients requiring a 1-hour CT received this within 1 hour. Only 56% of the patients receiving a CT had their report issued within 1 hour. There was also insufficient documentation within the fall reviews, with only 36% of patients having the presence or absence of all 1-hour or 8-hour CT criteria documented.
More education needs to be delivered to the teams regarding inpatient falls reviews/documentation, and potentially a falls template on the electronic patient record introduced. Quicker scanning and reporting times are also needed. There is currently insufficient evidence relating to what effect anticoagulants, antiplatelet agents and prophylactic heparins have on the risk of intracranial bleeding following head injury – larger studies are required. The project will be repeated in 1 year.