Article Text

PDF

P-20 A retrospective audit of blood pressure, orthostatic hypotension and falls in advanced cancer
  1. Amy P Worrall1,
  2. Ciarán Doyle1,
  3. Roisí­n Ní­ Dhomhnaill1 and
  4. Declan Walsh2
  1. 1School of Medicine, Trinity College Dublin, Dublin 2, Ireland
  2. 2Our Lady’s Hospice and Care Services, Harold’s Cross, Dublin

Abstract

Background Orthostatic Hypotension (OH) is a drop of ≥20?mmHg systolic blood pressure (BP) and/or diastolic 10?mmHg within 3 minutes of orthostatic stress.1 OH seems highly prevalent in advanced cancer. Comorbidities and anti-hypertensives increase OH risk and falls risk. Consequently cancer patients in palliative settings are high fall risks.2

Objectives BP and OH measurement practices and post-fall interventions were audited amongst in-patients with advanced cancer.

Methods A retrospective analysis of four consecutive months of cancer admissions to a specialist palliative care unit was conducted. Data was obtained from 168 non-randomly selected clinical records. Information recorded included: demographics, falls risk assessment, falls occurrence, BP and relevant medications. The audit was against standards for current institutional clinical policies.

Findings Of 168 admissions, 136 (81%) had the Falls Risk Screening Tool completed. 143 of them (85%) had BP recorded, while 25 (15%) did not. There were 7 falls during the first week post-admission. Post-fall, 5 had BP measured; 2 did not. Only 1 of the 7 who fell had OH measured.

Conclusions During the audit period none of clinical standards were fully completed. There were 7 falls in one week and only 1 had the required OH measurement conducted. Some admission tools were misinterpreted or were ambiguous. Review of institutional admission tools could increase compliance and clinical standard adherence, especially if tailored for a palliative care cohort. OH may be underdiagnosed.

References

  1. . Chambers JC. Should we screen hospice inpatients for orthostatic hypotension?PalliativeMedicine 2005;19(4):314–8.

  2. . Stone CA, Lawlor PG, Kenny RA. How to identify patients with cancer at risk of falling: a review of the evidence. Journal of Palliative Medicine 2011;14;(2):221–230.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.