Vestibular Assessment In Patients With Self-Reported Dizziness And A History Of Falls

Abstract Background World Falls Guidelines recommend that any patient with a history of falls and reporting dizziness should be screened for Benign Paroxysmal Positional Vertigo (BPPV) (Montero-Odasso et al.,2022). Diagnosing and treating BPPV in particular has been shown to reduce the incidence of falls in older adults, however, it is widely underdiagnosed (Li et al., 2023). This audit explored compliance with falls guidelines in a day hospital setting where falls work up assessments take place on older patients (75 years and older). It aimed to identify reasons why vestibular assessments may not have been undertaken and establish methods to improve compliance with the undertaking of vestibular assessments where indicated. Methods A retrospective chart was undertaken for patients who attended a day hospital service for older adults between January and April 2023. A Microsoft excel sheet was used to track data. All data was anonymised and stored on a password encrypted HSE networked drive accessed in the day hospital. Results A total of 97 charts were reviewed, with 31 patients reporting to have experienced dizziness with falls. For 33% of those patients (n=10), a vestibular screen was not carried out. For 7 out of 10 of these patients a screen was not carried out due to insufficient staff training in the area, with one patient not having been referred to physiotherapy, also secondary to insufficient staff training. Conclusion Facilitating adequate access to training in vestibular rehab for healthcare professionals is an essential part of ensuring BPPV and other vestibular disorders are diagnosed and treated in patients with self-reported dizziness and falls. Training as part of undergraduate degrees could be considered to ensure BPPV is diagnosed and treated in a timely manner. Additional staff training was provided in the day hospital setting in question and a re-audit of vestibular screening will take place in summer 2024.