Impact of a Nurse-led Ambulatory 5-day Tape Application in a Falls Multidisciplinary Clinic
Abstract
Introduction
Cardiac arrythmias are a known cause of falls. The World Falls Guideline advocates initial cardiac assessment with 12-lead electrocardiogram (ECG), and further monitoring if no abnormalities are detected but history suggests syncope. The falls MDT clinic includes assessment by a nurse, physiotherapist, and pharmacist. This information is discussed with a geriatric consultant the following week for decision regarding medical review.
Historically, following ECG and assessment the decision about further monitoring was made later by the consultant. This led to delays in diagnosis, inconvenience for patients and additional appointments. We trialled nurse-led decision making for 5-day tape application during the initial MDT clinic.
Methods
From 1/1/25-31/12/25, patients attending the MDT clinic had a falls history and ECG taken by the nurse. If they met pre-defined criteria, or it was deemed clinically appropriate a 5-day tape was applied.
Following consultant review, any patients still requiring a 5-day tape were contacted to have the tape applied post clinic.
Data were collected in Microsoft Excel for all patients attending the clinic including demographics, decision made by nurse/consultant, changes to treatment or cardiology referrals.
Results
112 patients were seen in 28 MDT clinics.
46 (41%) received a 5-day tape. Half (48%) of these tapes were applied in clinic following nurse decision. Treatment was changed or the patient was referred for intervention in 24 (52%) of cases. 10/22 (45%) nurse-led tapes led to intervention, similar to consultant recommended tapes which were 14/24 (58%)
Conclusion
A substantial proportion of patients had a 5-day tape applied in clinic, leading to treatment changes or cardiology referral. Nurse-led decision halved the number of patients requiring additional appointments for tape application with none deemed inappropriate. Future plans focus on increasing nurse experience and confidence.
Comments
Great work
Great work showing proactive use of five day heart monitors picking up a range of clinically important findings!
Nurse lead role and future view
This is a great research poster with a positive view on nurse lead ambulatory monitoring.
How does this affect the nurse lead role in the future and what wider approach could be undertaken?
How did the patients find the experience of the multidisciplinary team approach and then leaving with a ambulatory monitor?
Thank you for your questions…
Thank you for your questions-
We very much want to provide sustainability by ensuring ongoing training for future staff joining the clinic. It would be great to be able to provide a community service also, but currently resources do not allow this.
Patients generally provide positive feedback regarding having the tape put on in clinic but they can find the whole process of clinic tiring. Some patients prefer to come back to clinic at another time (and we fit them in between the clinic patients for that day). They do like the fact that they know where they are coming and who they will see, and we try to make the return process as easy as possible.
Great looking poster
Good to see the impact of earlier intervention and reducing future appointments. What treatment changes in particular were the most common following the 5 day tape?
amazing poster
This really shows that an MDT approach where tests can be done on the day improves experience for patients and outcomes and tests can be carried out in a timely manner.
Thank you for your question…
Thank you for your question.
The most common treatment change was introduction or reduction of betablockers (including eye drops) with a follow up tape to check effectiveness.
We also had one patient who required a pacemaker and several patients that required input from Cardiology.