Preventing falls in hospitalized elderly: design and validation of a team intervention

Rev. Latino-Am. Enfermagem

Dixe

Madeira

et al. 2020

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Objective: determine the psychometric properties of the safety practices and behaviors dimension of the Scale of Practices and Behaviors of Institutionalized Elderly People to Prevent Falls in a sample of elderly people with cognitive decline. Method: methodological study, with a quantitative approach, to assess the psychometric properties of the mentioned scale in a sample with 102 elderly people with cognitive decline who lived in two long-term care institutions for the public in this age group. Internal consistency evaluation was carried out by calculating the Cronbach’s alpha coefficient; interobserver reliability was expressed by Cohen’s kappa coefficient; and temporal stability, by obtaining Spearman correlation. Compliance with all ethical procedures was observed. Results: the dimension of safety practices and behaviors showed α = 0.895 for its 11 items. Seven out of the 11 items reached good to excellent agreement among the experts for interobserver reliability. Kappa index values indicated that the instrument is valid and reliable. Safety practices and behaviors were influenced by institutionalization time, being at least 85 years old, and gait skills. Conclusion: the results pointed out that the instrument has good reproducibility and is valid and reliable, which allows its use in clinical practice in elderly people with cognitive decline as well as in research.

Section: Discussionmentioning

confidence: 99%

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls

Rev. Latino-Am. Enfermagem

Dixe

Madeira

et al. 2020

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“…The differentiated care nurse's intervention must consist of carrying out a follow-up that assesses the effectiveness of interventions related to the caregiver's training. Such a strategy has benefits such as reducing caregiver burden, better access to care, reducing unanswered needs, improving the ability to live at home or in the community, reducing hospitalizations and care in residential structures for the elderly people, reducing costs, stress and increasing well-being, as it provides support, information and continuing education [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…The bet on the safe hospital-community transition, guaranteeing continuity of care and improving its quality, contributes to the reduction of costs and presents itself as an appropriate strategy and policy to be followed by health services, even in situations of pandemic [1,3,4,6,19,24,25], because the lack of articulation can result in confusing treatment guidelines for the person, with a strong probability of non-compliance with good practices and duplications, in an inadequate follow-up, as well as in a lack of preparation/information for the user and informal caregivers [4][5][6][22][23][24][25]. In this sense, it should be noted that the acute illness of a family member, accompanied by disability, dependence and/or in need of managing a therapeutic regime, may involve the preparation of one or more family members or significant people to support it.…”

Section: Discussionmentioning

confidence: 99%

Transitional Care in Times of COVID 19: Opportunities for e-Health Interventions

Lecture Notes in Bioengineering

Sousa

Ferreira

2021

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People admitted to hospitals are vulnerable to experiencing care continuity loss when there are alterations in their health condition or when they are transferred between care institutions. This is a challenge for health systems to guarantee the execution of a set of actions whose objective is ensuring care continuity between different care levels. This studied aimed to understand the influence of the current pandemic on the continuity of care between the hospital and the community. The participants were five nurses, who gave free and informed consent to participate. Content analysis was the technique used in data analysis. Data anonymity and confidentiality were ensured, and the data was coded without identifying customers and their families. An ethic commission authorized the study. The findings shows that transitional care has become a missing care during the pandemic, due to the need to reorganize the services and teams to provide care to the COVID patients and by the limitations of visits to hospitalized elderly. Professionals note that not only the discharge preparation and caregiver training were affected, but also communication with primary health care became more difficult, with clear defragmentation in the transitional care. In the professionals' discourse, the need to rethink ways of ensuring continuity of care emerges, with e-health interventions being seen as an opportunity to ensure the safety of the elderly and their caregivers, the articulation with colleagues in primary health care and continuity of rehabilitation care. Despite the limitations of the study, several recommendations for the clinic and investigation emerge.

“…19 Communication between professionals -but also between residents and professionals -about preventive measures and health promotion can ensure that appropriate and specific interventions are carried out to decrease the incidence of falls. 10,19 Previous work has shown that team training can help reduce falls 19 and the outcomes of this study lend further weight to the need for investment in training of teams, including post-fall reporting and action. 20 Client safety in nursing care depends on the high quality of care provided by nurses and other professionals, and excellent communication and team work.…”

Section: Discussionmentioning

confidence: 99%

Practices and behaviors of professionals after falls in institutionalized elderly with and without cognitive decline

Dixe

2020

Dement. neuropsychol.

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Falls are a major problem in nursing homes due to their high prevalence and impact on the functioning of elderly. Objective: This study aims to: a) construct and validate a scale for assessing the practices and behaviors of professionals from nursing homes after falls in elderly; b) describe practices and behaviors after falls; and c) associate practices and behaviors with professionals’ length of experience, training and age. Methods: This is a correlational study, conducted in a sample of 152 professionals from six nursing homes. The study adhered to all of the Declaration of Helsinki principles. Results: The scale constructed has a Cronbach’s alpha of 0.938. The 12 items of the scale are grouped into two factors. The most expressive indicators are the communication of fall episodes that result in severe injuries (4.64 ± 0.812) and the communication of falls that result in injuries and need intervention from health technicians (4.61 ± 0.832). We found no significant statistical difference between length of professional experience, training and age when associated with professional practices and behaviors after falls in elderly (p > 0.05). Conclusion: Future studies should investigate the association of post-fall professional practices and behaviors with fear of another fall, fall recurrence, and changes in functioning of the elderly following a fall.