falls are a major health problem, and efforts to lower the risk of falling in the community setting are needed, 1 but a fall is also one of the most serious iatrogenic events that an elderly person requiring hospitalization might experience. Approximately 5% to 10% of community-dwelling elderly people who fall sustain a significant injury. 2 It is likely that a greater percentage of falls results in such an injury if the elderly person is acutely ill and unable to protect herself during the fall. Multiple factors, including poor vision, delirium, pharmaceuticals, a hazardous environment, and chronic dementing illness may contribute to a greater risk of falling. 3 One program, the Hospital Elder Life Program, designed to decrease the incidence of delirium in the hospital setting, has been shown to decrease the risk of falls. 4 Notwithstanding such efforts, falls in the hospital setting remain a matter of considerable concern to patients, their families, their physicians, and hospital administrators.To address this, a video monitoring system was put in place at Hackensack University Medical Center on a 33-bed unit that serves the older population almost exclusively. Eight individuals deemed to be at high risk of falling were located in adjoining rooms, and video cameras were directed at their beds. To protect the privacy of the individuals when nursing care was being provided, the monitors were located in such a way that the patient in the bed could not be seen if the curtains were fully drawn.Individuals selected to occupy these beds were aged 70 and older and acutely ill. In addition, they had a diagnosis of delirium or dementia and a history of a fall in the recent past. Initially, a nursing assistant observed all eight beds continuously during the night shift on a single video screen. Each attendant received an educational program targeted to fall prevention. If a patient appeared to be about to fall, the nursing assistant intervened immediately.During the first full year of this program, 72 falls occurred on the 33-bed unit, with more than 50% of them happening at night, but not a single individual in a monitored bed fell at night during the year. Because of its initial success, the monitoring program has been expanded to be in place throughout the 24-hour period. The only fall by a monitored individual during this period occurred when two patients were observed to be ready to fall at the same time, and the assistant was unable to reach the second elder in time.Although no data are available at this time, it seems likely that this video-monitoring program would not only improve outcomes, but would also save money directly, lower legal costs, and improve patient satisfaction. In addition, in the near future, Medicare might not pay for the acute care of an individual who sustains an iatrogenic event, such as a fall-related injury, that occurred during hospitalization.

Improving nursing communication skills and HCAHPS scores

There was a higher rate of HDP in urban indigenous women compared to the national indigenous prevalence. The family history, or individual history of hypertension was the most significant risk factors and BMI was not identified as a risk factor for HDP in this population.

No abstract

In this study, the difference in the number of initial credits between incoming transfer and first-year students entering a land grant university in a professional education program was examined (N = 488). A multivariate analysis of variance revealed that transfer students transferred significantly more total credits and more credits that counted toward degree programs than did first-year students. Undergraduates who had graduated from small high schools transferred more credits and more credits that counted than did those from large high schools. However, first-year students transferred a significantly higher percentage of total credits that counted toward the degree programs than did transfer students. Implications for advisors, institutions, and policy makers are discussed.