Harbison Alicia J, Prabhu Sheela
Family Medicine, Transcend Medical Group, Pantego, USA.
Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA.
Cureus. 2019 Dec 30;11(12):e6513. doi: 10.7759/cureus.6513.
Introduction One-third of people aged 65 years of age and older fall annually.Vitamin D is key in maintaining muscle mass and bone structure. The purpose of this quality improvement project is to evaluate the current treatment of elderly patients who experience falls, educate providers on the importance of vitamin D, and measure the changes. Methods We obtained baseline data from the electronic medical records (EMR) of patients who had experienced falls from over a two-year period. We also surveyed providers from the departments of internal medicine (IM) and family medicine (FM) to evaluate fall treatment, educated providers on new protocols, reviewed EMRs of patients that had fallen and surveyed FM and IM providers after education. Results We found that vitamin D supplementation and home health (HH) referral were marginally improved after education and that significant improvement was found in patients being referred to physical therapy (PT). Conclusion Establishing a fall treatment protocol leads to more consistent care among FM and IM providers. Reviewing and updating of the protocol based on outcomes and subsequent research is recommended for improvement in patient care.
引言 每年有三分之一的65岁及以上老年人跌倒。维生素D对于维持肌肉质量和骨骼结构至关重要。本质量改进项目的目的是评估当前对跌倒老年患者的治疗情况，就维生素D的重要性对医疗服务提供者进行教育，并衡量相关变化。方法 我们从两年多来跌倒患者的电子病历（EMR）中获取基线数据。我们还对内科学（IM）和家庭医学（FM）科室的医疗服务提供者进行了调查，以评估跌倒治疗情况，就新方案对医疗服务提供者进行教育，复查跌倒患者的电子病历，并在教育后对FM和IM科室的医疗服务提供者进行调查。结果 我们发现，教育后维生素D补充和家庭健康（HH）转诊略有改善，而被转诊至物理治疗（PT）的患者有显著改善。结论 制定跌倒治疗方案可使FM和IM科室的医疗服务提供者提供更一致的护理。建议根据结果和后续研究对方案进行审查和更新，以改善患者护理。
