Impact of a Nurse-led Ambulatory 5-day Tape Application in a Falls Multidisciplinary Clinic

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.