a Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, Ústav ošetřovatelství, porodní asistence a neodkladné péče, České Budějovice, Česká republika b Západočeská univerzita v Plzni, Fakulta zdravotnických studií, katedra ošetřovatelství a porodní asistence, Plzeň, Česká republikaThe goal was to write a review article which would summarize the conclusions of empirical studies on the effectiveness of preventive programs established in hospitals over the last 5 years. Incorporated research studies were found by using seven electronic databases on nursing and related health professional research (full text databases: Cinahl, Ebsco, Nursing Ovid, ProQuest STM+ Hospital Collection -Medline, Science Direct and citation databases PubMed and Scopus) entering keywords: accidental falls, effectiveness, fall prevention programs, institution. Other search criteria were: full text, reviewed publications, English language, human subject (human) and research results published within the last 5 years (namely 2011-2016).Twelve research studies meeting the required criteria were incorporated in the final review. The most often mentioned intervention strategy was the education of patients and staff. Whether the programs, which were focused on educational influence, are effective depends on areas involving the so called "soft-factors", i.e. compliance, leadership, and proper team training, along with information technology support, both with staff and -in certain fields -patients.Curriculums of the currently preferred multifaceted intervention program involve education. The focus and course of the education process should correspond with the information from the field of fall prevention, gained by evidence-based nursing, and respect the individual assessment of each patient, as is stated by most authors of related research studies. S O U H R N Cílem přehledové studie bylo shrnout závěry empirických výzkumů o efektivitě zavedených preventivních programů v oblasti pádů pacientů či klientů nemocničních zařízení s poskytovanou ošetřovatelskou péčí za uplynulých 5 let. * Korespondenční autor: PhDr. Jana Horová, Západočeská univerzita v Plzni, Fakulta zdravotnických studií, katedra ošetřovatelství a porodní asistence, Náměstí Odboje 18, 301 00 Plzeň, Česká republika, (Print) • ISSN 1804-7122 (Online) o š e t ř o v a t e l s t v í Článek citujte takto: Horová J, Brabcová I, Krocová J. The effectiveness of intervention programs for preventing patients from falls. Kontakt 2017; 19(2): e105-e115; http://dx.

Objectives Patient falls deteriorate patients’ functional condition and quality of life, and increase their treatment costs. E-learning is considered an effective way to gain knowledge and competencies for quality and safety in nursing practice. The aim of the study is to evaluate the effectiveness of an e-learning course for nurses in preventing in-patient falls. Methods The research design was mixed. In the first phase of the study, a five-year retrospective analysis of 2,280 in-patient falls was performed. Based on the analysis of risk factors for patient falls and group interviews with clinic managers an e-learning course was designed and completed by 250 nurses from five surgical and internal departments. The course’s effectiveness was evaluated based on the incidence of patient falls and the consequences of the falls before and after e-learning. Results At surgical departments, there was a statistically significant decrease in patient fall indices after the implementation of the e-learning course (from 4.4 to 2.6 falls per 1,000 patients; p=0.022). On the contrary, in internal departments, this index increased in the monitored period (from 19.0 to 26.9 falls per 1,000 patients; p=0.001). In all departments, there was a decrease in the incidence of patient injuries caused by falls after the implementation of the e-learning course; in internal medicine, this decrease was statistically significant (from 54.5% to 33.3%; p=0.014). Conclusions The study confirmed that e-learning forms of education for healthcare professionals have a positive effect in preventing patient falls.

Rizikové faktory pádů pacientů bývají často multifaktoriální. V rámci poskytování bezpečné zdravotní péče je nutné tyto faktory včas a správně detekovat. V českém prostředí je doporučeno využívat jako nejefektivnější škály Morse Fall Scale a The Conley Scale. Pro hodnocení rizika pádů u dětských pacientů neexistuje jednoznačný konsenzus. Klíčová slova: pád, pacient, rizikové faktory, hodnoticí nástroje. Risk assessment of falls Risk factors for patients fall are often multifactorial. As part of the provision of safe health care, risk factors must be detected in a timely and correct manner. In the Czech environment it is recommended to use Morse Fall Scale and The Conley Scale as the most effective scales. There is no clear consensus for evaluating risk factors of falls for pediatric patients.

Purpose: Hormonal receptor (HR) status is one of the key factors when determining the treatment of breast cancer. Even though HR conversion is one of the most researched topics recently, most of the previous studies include only the results of biopsies instead of samples obtained by metastasectomy. Aim: The aim of this study is to compare the occurrence of HR status conversion in brain breast cancer metastatic tissue to other localities. Methods: A total of 50 patients after breast cancer metastasectomy of brain, lung or liver were included in the study. The clinical characteristics were recorded. Results: HR conversion was observed in a total of 30 cases (60.0%), while HER2 (human epidermal growth factor receptor 2) discrepancy occurred only in one case (2.0%). Endocrine therapy significantly contributed to the decrease progesterone and estrogen receptor expression in metastatic tissue compared to the primary tumor (p = 0.009, p = 0.023; respectively). Triple negativity was more common in the brain metastases (p = 0.039). Liver metastases occurred in significantly younger patients (p = 0.034), however brain metastases had the poorest OS (p = 0.007). Conclusion: HR conversion occurs in more than 50% of cases of breast cancer metastatic disease, while HER2 discrepancy is rare. Hormonal therapy significantly contributes to the decrease of HR positivity in metastases. Triple negativity is more common in the brain metastases than in other localities. Brain metastases of breast cancer are associated with the poorest prognosis.