Overutilization of CT scans of the brain in nursing home patients post fall
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The use of head computed tomography (CT) scans are being overutilized in the nursing home setting following patient falls. The decision to perform head CT scans on post-fall patients is
being made without using current best practice protocols. The primary focus of this quality improvement project was to determine the effect of implementing the Canadian CT Head Rule (CCHR) during assessment of nursing home patients post fall compared to the current practice of obtaining a CT of the head on all patients. The plan, do, study, act (PDSA) model was utilized to make this practice change. Patients who fell were assessed according to the nursing home’s current policy in addition to use of the CCHR. Pre and post surveys were also administered to the nursing staff to determine their knowledge, attitudes, and beliefs of their current practice and use of the CCHR. Of the total number of patients sustaining a fall, there was a 100% correlation with the CCHR on the need for a CT scan post fall and 100% had negative findings on their head CT scans. Overall, nurses felt incorporating the CCHR into their current policy would eliminate unnecessary transfers, improve patient management post-fall, and decrease their overall workload. This quality improvement project reveals that changes in practice may be considered when determining the need for head CT scans on patients post fall in the nursing home.
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Type | DNP Capstone Project |
Acquisition | Self-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Clinical Practice Guideline(s) |
Research Approach | N/A |
Keywords | Overutilization CT Scans; Patients Post Fall |
CINAHL Subject(s) | Nursing Home Patients; Health Services Misuse; Health Services Misuse--Trends; Tomography, X-Ray Computed; Tomography, X-Ray Computed--Utilization; Unnecessary Procedures; Accidental Falls |
Grantor | Capella University |
Advisor | Jones, Terri S.; Washington, Carolyn; Sanders-Cepeda, Diane |
Level | DNP |
Year | 2017 |
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