Evidence-Based Protocol: Fall Prevention for Older Adults

ArticleinJournal of Gerontological Nursing 31(11):9-14 · December 2005with18 Reads
DOI: 10.3928/0098-9134-20051101-05 · Source: PubMed
    • "How does society today perceive security and what are the external and inner sources of security for older people? Most research has assessed the different kinds of risk that older people may face while receiving care, for example, the risk of falling (Lyons 2005), problems with medication (Frazier 2005), risk of injuries, risk of infections (Tew et al. 2005), risk in relation to diseases (Tokish et al. 2004) and so forth. Surprisingly, qualitative studies on sense of security seem to be missing. "
    [Show abstract] [Hide abstract] ABSTRACT: This paper is a report of a study exploring possible external and inner sources of the sense of security felt by older people aged 65 and 75. Background.  The concept of 'security' has been parsimoniously defined and explored, especially as pertains to older people, and previous research has primarily focused on risks in relation to individuals' declining health and functional ability. In 2005, population-based cross-sectional surveys were carried out in 15 municipalities in Västerbotten, Sweden and 18 municipalities in Ostrobothnia, Finland. A 15-page questionnaire (84 questions) was distributed, with the final total response rate reaching 68· % (n = 3370): 1825 Swedish-speaking Swedes, 926 Swedish-speaking Finns and 621 Finnish-speaking Finns. The statistical analysis was three-stage, including nominal stepwise regressions. Older people who indicate that they are 'very secure' are more likely to consider life meaningful and are able to master various life crises. Moreover, they possess confidence in economic institutions and are more likely to feel economically secure. Weak trust in family and friends or neighbours and decreased functional ability seem to indicate a subjective feeling of 'insecurity'. Caregivers in health care should focus more on supporting older persons' meaningfulness in life and how their feelings of security can be strengthened by trusting relationships and activities. In nursing, there should be more focus on developing knowledge of inner health resources, including positive life orientation and meaningfulness in life.
    Full-text · Article · Jun 2011
    • "In this study a fall was defined as a '. . . rapidly decent of body from a higher to a lower level due to disturbed balance of the body or reduced capacity to bear weight of body in different positions' [28,29]. Guidelines were defined as: 'clinical practice guidelines are statements derived from the best available evidence for making decisions about the care of specified populations. "
    [Show abstract] [Hide abstract] ABSTRACT: Falls and fall-related injuries are major problems in hospitals. The aim of this study was to examine the impact of fall prevention guidelines on falls and fall-related injuries in hospitals. A cross-sectional study was conducted in German hospitals. Some 28 hospitals participated with a total of 5046 patients. Eleven of these hospitals had already implemented a fall prevention guideline, 10 were in the process of developing such a guideline and seven hospitals were not using any fall prevention guideline at all. A standardized questionnaire was used on the individual patient level to obtain details regarding the socio-demographic background, falls, fall-related injuries and other problems relevant to nursing. A further questionnaire referred to the use of fall prevention guidelines in the individual hospitals. Data specific to falls were analysed both on hospital level and on ward and patient level by means of a multilevel logistic model. The univariate analyses suggest that patients in hospitals that are using guidelines are more likely to fall [odds ratios (OR) = 1.19, confidential interval (CI) = 0.65-2.18] than in hospitals that do not use any guideline (reference category) or are still in the developing stage (OR = 0.82, KI = 0.77-0.87). If, in a multivariate analysis, the ward level and individual patient variables (age, disorientation, confusion, incontinence) are included, the following results are obtained: the probability of falls in hospitals not using guidelines (reference category) is higher than in hospitals developing a guideline (OR = 0.86, KI = 0.58-1.28) or using a guideline (OR = 0.71, KI = 0.44-1.14). The differences are even more distinct regarding the injuries resulting from a fall that require medical treatment. The probability of these injuries is significantly lower in hospitals using guidelines (OR = 0.27, KI = 0.09-0.85) than in hospitals developing a guideline (OR = 0.61, KI = 0.24-1.54) or not using any guidelines at all (reference category). The present results of the multilevel analysis show that falls and fall-related injuries can be reduced by the implementation of fall prevention guidelines.
    Full-text · Article · Mar 2010
    • "A number of researchers [12,141516 claimed that elderly women had a higher risk of sustaining an injurious fall but the findings of Fletcher and Hirdes [17] said otherwise. Research also indicated that individuals with a history of fall tended to suffer from recurrent falls [18] and were three times more likely to incur falls in the future [12]. A mix of medical problems appears as very common causes in elderly falls. "
    [Show abstract] [Hide abstract] ABSTRACT: Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh) and Standard Deviational Ellipse (SDE) techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies.
    Full-text · Article · Feb 2009
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