Picot questions related to falls

P I C O T ASSIGNMENT

QUESTION: What Is the effectiveness of restraints in reducing the occurrence of falls in patients 65 and over in nursing homes.

P – Patients 65 and over

I – Restraints

C – Besides safety alarm/rails

O – Decreased falls.

T – 1 year ( if needed)

PEER REVIEW ARTICLES - Qualitative Research

1.

Vandenberg, Ann E. Johnson, Theodore M., II van Beijnum, Bert-Jan Overdevest, Vera G. P. Capezuti, Elizabeth

Source:

GERIATRIC NURSING ; JUL-AUG 2017, 38 4, p276-p282, 7p.

Publisher Copyright:

MOSBY-ELSEVIER

ISSN:

01974572

Document Type:

Journal

Author Keywords:

Fall prevention Long-term care Monitoring technology Position monitors Bed exit alarms Pressure sensor mats Alarm fatigue

KeyWords Plus:

LONG-TERM-CARE OF-THE-ART INTERVENTION ADULTS

Abstract:

Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning exchange with a Dutch nursing home. We constructed two case reports from interview and observational data and compared the magnitude of falls, safety cultures, and technology characteristics and effectiveness. Falls were a high-magnitude problem at the US site, with a collectively vigilant safety culture attending to non-directional audible alarms; falls were a low-magnitude problem at the NL site which employed customizable, infrared sensors that directed text alerts to assigned staff members' mobile devices in patient-centered care culture. Across cases, 1) a coordinated communication system was essential in facilitating effective fall prevention alert response, and 2) nursing home safety culture is tightly associated with the chosen technological system. (C) 2016 Elsevier Inc. All rights reserved.

Language:

English

Accession Number:

000408180800002

Database:

Social Sciences Citation Index

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2.

Horton K

Affiliation:

Centre for Research in Nursing and Midwifery Education, Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7TE United Kingdom. K.Horton@surrey.ac.uk

Source:

Journal of Rehabilitation Research & Development (J REHABIL RES DEV), 2008; 45(8): 1183-1194. (12p)

Publication Type:

Journal Article - research, tables/charts

Language:

English

Major Subjects:

Accidental Falls -- Prevention and Control -- In Old Age Accidents, Home -- Prevention and Control -- In Old Age Rehabilitation, Geriatric Security Measures, Electronic Telehealth

Minor Subjects:

Aged; Aged, 80 and Over; Community Living; Control (Psychology); Descriptive Statistics; England; Fear; Female; Geriatric Assessment; Interviews; Male; Patient Compliance; Qualitative Studies; Thematic Analysis; Whites; Human

Abstract:

This article reports the qualitative element of an observational study that examined whether an extended alarm service using fall detectors and bed occupancy sensors could reduce fear of falling among community-dwelling older people who had recurrent falls. The 17 participants in the intervention group used the extended alarm service while the 18 in the control group used a standard pendant alarm. Individual interviews were tape-recorded and transcribed. The participants' fall history and whether they were afraid of falling were also explored. Interview questions were grounded in theories relating to falls and queried participants in the intervention group about their expectations of and experiences with the use of telemonitoring devices; those in the control group were asked whether they would consider using such devices in the future. Key themes from the analysis were expectations, feelings of security, call center support, barriers to using assistive devices, and adherence and likelihood of using telemonitoring devices. Older people found that the use of telemonitoring gave them 'a greater sense of security' and enabled them to remain in their home. However, some found the devices 'intrusive' and did not feel they were in control of alerting the call center, which played a key role in their adherence to using the devices.

Journal Subset:

Allied Health; Blind Peer Reviewed; Peer Reviewed; USA

Special Interest:

Gerontologic Care

ISSN:

0748-7711

MEDLINE Info:

PMID: 19235119 NLM UID: 8410047

Entry Date:

20090626

Revision Date:

20151015

Accession Number:

105511991

Database:

CINAHL Complete

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3.

JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT ; 2008, 45 8, p1183-p1194, 12p.

Publisher Copyright:

JOURNAL REHAB RES & DEV

ISSN:

07487711

Document Type:

Journal

Author Keywords:

assistive devices bed occupancy sensor community setting fall detector falls fear of falling observational study older people rehabilitation telemonitoring

KeyWords Plus:

FEAR EFFICACY HOME TELECARE BALANCE HEALTH IMPACT STATE

Abstract:

This article reports the qualitative element of an observational Study that examined whether an extended alarm service using fall detectors and bed occupancy sensors could reduce fear of falling among community-dwelling older people who had recurrent falls. The 17 participants in the intervention group used the extended alarm service while the 18 in the control group used a standard pendant alarm. Individual interviews were tape-recorded and transcribed. The participants' fall history and whether they were afraid of falling were also explored. Interview questions were grounded in theories relating to falls and queried participants in the intervention group about their expectations of and experiences with the use of telemonitoring devices; those in the control group were asked whether they would consider using such devices in the future. Key themes from the analysis were expectations, feelings of security, call center support, barriers to using assistive devices, and adherence and likelihood Of using telemonitoring devices. Older people found that the use of telemonitoring gave them "a greater sense of security" and enabled them to remain in their home. However, some found the devices "intrusive" and did not feel they were in control of alerting the call center, which played a key role in their adherence to using the devices.

Language:

English

Accession Number:

000262456800008

Database:

Social Sciences Citation Index

Images:

·

· ChartTable 1 ChartTable 2

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Quantitative Research- Peer review

1.

Butcher M

Source:

Nursing & Residential Care (NURS RESIDENTIAL CARE), Feb2010; 12(2): 77-79. (3p)

Publication Type:

Journal Article - pictorial

Language:

English

Major Subjects:

Accidental Falls -- Prevention and Control Beds and Mattresses Liability, Legal Organizational Compliance

Minor Subjects:

Patient Safety; Residential Care; Risk Assessment

Abstract:

This article looks at the background behind bed-rail regulation development and warns care home owners and managers that they have a legal requirement to implement systems to ensure.

Journal Subset:

Core Nursing; Double Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Nursing; Peer Reviewed; UK & Ireland

ISSN:

1465-9301

MEDLINE Info:

NLM UID: 100897386

Entry Date:

20100402

Revision Date:

20150820

Accession Number:

105122268

Database:

CINAHL Complete

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2.

Hignett, Sue Fray, Mike Hignett, Sue Sands, Gina Fray, Mike Xanthopoulou, Penny Healey, Frances

Source:

AGE AND AGEING ; JUL 2013, 42 4, p531-p535, 5p.

Publisher Copyright:

OXFORD UNIV PRESS

ISSN:

00020729

Document Type:

Journal

Author Keywords:

bed rails side rails restraint prevalence rationale older people

KeyWords Plus:

PHYSICAL RESTRAINTS BEDRAILS FALLS CARE HOSPITALS DATABASE SAFETY RISK

Abstract:

Background: the design and use of bed rails has been contentious since the 1950s with benefits including safety, mobility support and access to bed controls and disadvantages associated with entrapment and restraint. Objective: to explore which bed designs and patient characteristics (mobility, cognitive status and age) influence the likelihood of rails being used on UK medical wards. Method: the use of rails was surveyed overnight at 18 hospitals between July 2010 and February 2011. Results: data were collected on 2,219 beds with 1,799 included (occupied). Eighty-six percent had rails attached; 52% had raised rails (42% had all raised). Adjusted logistic regression results suggest a significantly increased likelihood of rail use for (i) electric profiling beds and ultra low beds; (ii) > 80 years; (iii) described as having any level of confusion or mobility impairment. These variables together explained similar to 55% of the variance in rail use. The most frequently mentioned reason for raising rails was 'to prevent falls from the bed' (61%) especially for patients described as confused (75%). Conclusion: there were indications that rails were being used inappropriately (as a restraint) for both confused patients and those needing assistance to mobilise.

Language:

English

Accession Number:

000320855700021

Database:

Social Sciences Citation Index

Images:

·

· Chart Chart

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3.

Melissa de Freitas Luzia Miriam de Abreu Almeida Amália de Fátima Lucena

Source:

Revista da Escola de Enfermagem da USP, Vol 48, Iss 4, Pp 632-640 (2014)

Publisher Information:

Universidade de São Paulo, 2014.

Publication Year:

2014

Collection:

LCC:Nursing LCC:Medicine

Subject Terms:

Diagnóstico de enfermería Cuidados de enfermería Accidentes por caídas Pacientes internos Hospitalización Nursing Medicine

Description:

Objective: Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). Method: A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. Results: The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients’ belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. Conclusion: The treatment prescribed in clinical practice was corroborated by the NIC reference.

Document Type:

article

File Description:

electronic resource

Language:

English Portuguese Spanish; Castilian

ISSN:

1980-220X 0080-6234

Relation:

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000400632&lng=en&tlng=en; https://doaj.org/toc/1980-220X

DOI:

10.1590/S0080-623420140000400009

Access URL:

https://doaj.org/article/c5e84bcf606f45bbba54b5aab2da3780

Rights:

Journal Licence: CC BY

Accession Number:

edsdoj.5e84bcf606f45bbba54b5aab2da3780

Database:

Directory of Open Access Journals

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4.