Abstract

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.

Author Details

Drina Portman, DNP

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Clinical Practice Guideline(s)

Research Approach

N/A

Keywords:

Overutilization CT Scans, Patients Post Fall, Nursing Homes

Advisor

Terri S. Jones

Second Advisor

Carolyn Washington

Third Advisor

Diane Sanders-Cepeda

Degree

DNP

Degree Grantor

Capella University

Degree Year

2017

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2017-09-21

Full Text of Presentation

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