Background Fallen patients who remain immobile for prolonged periods are at risk of rhabdomyolysis and pressure ulcers. Local factors such as training, equipment, and policies may impact whether residential care staff call emergency services for the fallen patient, rather than residential staff managing their care. Methods We used routine computer-aided dispatch data within one urban Clinical Commissioning Group (CCG), during the period 1st April 2021 to 31st October 2021, identifying all falls attended by ambulance at nursing, care or residential facilities. We used the percentage of fallen patients not conveyed to hospital as a proxy measure suggesting that homes were calling ambulance services for patients who may only have needed assistance from the floor, while recognising that there are other reasons why patients may have ambulance attendance and not be transported. Results Within the CCG, there were 763 ambulance attendances for falls in nursing, care or residential facilities within the seven-month period, with a median response time of 87 minutes (IQR 28-207). 315 (41%) of these calls were non-conveyances. The calls came from 126 homes across the CCG, which demonstrated marked variation from 35 (28%) having no non-conveyed falls, through to 11 (9%) having only non-conveyed falls – no patients taken to hospital. We identified 17 homes who had both high rates of non-conveyed falls and high overall rates of fallers (top quintile for each), and shared this with the relevant CCG, who found that local factors such as ‘no-lift’ policies and lack of equipment do exist at some of these sites. Conclusions Fallen patients in residential homes experience long waits for ambulance care, but two-fifths of these patients receive no onward hospital transport. A low-burden query of routine data identified a group of care homes where initiatives around training, equipment and policies might improve the care of these patients.

中文翻译：

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03 家庭真相和漫长的谎言？救护车呼叫英国临床委托小组内住宿护理设施中的倒下患者

背景 长时间保持不动的跌倒患者存在横纹肌溶解症和压疮的风险。培训、设备和政策等当地因素可能会影响住院护理人员是否为倒下的患者呼叫紧急服务，而不是住院工作人员管理他们的护理。方法 我们在 2021 年 4 月 1 日至 2021 年 10 月 31 日期间，在一个城市临床调试小组 (CCG) 内使用常规计算机辅助调度数据，确定在护理、护理或住宿设施中由救护车参加的所有跌倒。我们使用没有被送往医院的倒下患者的百分比作为替代指标，表明家庭正在为可能只需要地面帮助的患者呼叫救护车服务，同时认识到患者可能需要救护车而不被运送的其他原因。结果 在 CCG 中，7 个月内有 763 名救护车因在护理、护理或住宿设施中跌倒而就诊，中位响应时间为 87 分钟（IQR 28-207）。这些电话中有 315 个（41%）是非交通运输。这些电话来自 CCG 的 126 个家庭，显示出从 35 个（28%）没有非转移性跌倒到 11 个（9%）只有非转移性跌倒的显着差异——没有患者被送往医院。我们确定了 17 所房屋的非承运人跌倒率和总体跌倒率都很高（每个房屋的跌倒率最高），并与相关的 CCG 分享了这一点，他们发现当地因素，如“禁止电梯”政策和缺乏的设备确实存在于其中一些站点。结论 寄宿家庭中倒下的患者等待救护车护理的时间很长，但这些患者中有五分之二没有接受后续的医院运输。对常规数据的低负担查询确定了一组疗养院，其中围绕培训、设备和政策的举措可能会改善对这些患者的护理。