A volunteer companion‐observer intervention reduces falls on an acute aged care ward

Donoghue, Judith; Graham, Jenny; Mitten-Lewis, Suzanne; Murphy, Moira; Gibbs, Julie

doi:10.1108/09526860510576947

Cited by 41 publications

(42 citation statements)

References 11 publications

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“…(14) Alternative uses for the sitter role have been seen as part of a preventative strategy for ‘wandering’ patients (8) and in fall prevention. (15,16) An alternative role for the sitter has included their use for ‘rooming’ with patients. This is when a family member or close friend stays in the patient’s room, and has been shown to be effective for elderly orthopaedic patients, as described by one study on post-operative elderly orthopaedic patients to assess its clinical impact on delirium rates.…”

Section: Resultsmentioning

confidence: 99%

The Role of Sitters in Delirium: an Update

Carr

2012

Can Geri J

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PurposeThe concept behind constant observation is not new. Whilst traditionally performed by nursing staff, it is now commonly performed by sitters. Details surrounding the usage, job description, training, clinical and cost effectiveness of sitters are not known; hence the reason for this review.MethodsA literature search was performed in MEDLINE, Cochrane Database of Systematic Reviews, and PubMed from the years 1960 to October 2011. The definition for sitter used in the articles was accepted for this review.ResultsFrom this review, it is evident that sitters are being employed in a variety of settings. The question of which type of person would provide the most benefit in the sitter role is still not clear; whilst sitters have typically included family and volunteers, it may be trained volunteers who may offer the most cost-effective solution. The paucity of information available regarding the training and assessments of sitters and the lack of formal guidelines regulating sitters’ use results in a lack of information available regarding these sitters, and current available evidence is conflicting regarding the benefits in terms of cost and clinical outcome. The only strong evidence relating to clinical benefit comes from the use of fully-trained sitters as part of a multi-interventional program (i.e., HELP)ConclusionsCurrent evidence supports a role for the sitter as part of the management of patients with delirium. The most cost-effective sitter role appears to be trained volunteers. Further research is needed to determine the specific type of training required for the sitter role. The creation of a national set of regulations or guidelines would provide safeguards in the industry to ensure safe and effective patient care.

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Section: Resultsmentioning

confidence: 99%

The Role of Sitters in Delirium: an Update

Carr

2012

Can Geri J

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“…Several conditions, such as Parkinson's disease, prior stroke, and hemiplegia, can induce various types of gait and mobility impairments that may increase the risk of falls and fallrelated injuries (Axer, Axer, Sauer, Witte, & Hagemann, 2010;Oliver, Daly, Martin, & McMurdo, 2004). Given that sitters have been used as a fall prevention strategy (e.g., Donoghue et al, 2005), the presence of gait and mobility impairments may be associated with increased sitter use. Validated coding rules were used to create a dichotomous variable that indicates the presence of one or more discharge diagnostic codes pertaining to gait and mobility impairments (Wilchesky, Tamblyn, & Huang, 2004).…”

Section: Rn Job Demand Indicators (Measure)mentioning

confidence: 99%

“…Sitters are unlicensed assistive healthcare providers whose functions are to provide close surveillance of at-risk patients and give an early warning signal to healthcare providers when the behavior of these patients deteriorates (Jaworowski et al, 2008;Rausch & Bjorklund, 2010;Tzeng, Yin, & Grunawalt, 2008). From the literature, sitters are most often used (a) for patients with behaviors that are potentially dangerous (e.g., agitated, wandering, suicidal) or that may interfere with medical therapies (e.g., pulling out lines and tubes) and (b) for patients at high risk of having a fall and fall-related injuries (e.g., Donoghue, Graham, Mitten-Lewis, Murphy, & Gibbs, 2005;Rausch & Bjorklund, 2010;Tzeng et al, 2008;Worley et al, 2000). Despite limited evidence about their effectiveness for preventing falls or other adverse events (Jaworowski et al, 2008;Rausch & Bjorklund, 2010;Torkelson & Dobal, 1999;Tzeng et al, 2008), an estimated 99% of U.S. hospitals use sitters, and the annual costs of sitter use have escalated in the last decade (Rausch & Bjorklund, 2010;Worley et al, 2000).…”

mentioning

confidence: 98%

Registered Nurses' Job Demands in Relation to Sitter Use

et al. 2011

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“…Although the cortical control of movement is well documented (Kalaska et al, 1997; Taylor et al, 2002; Carmena et al, 2003; Andersen et al, 2004; Donoghue et al, 2005; Lebedev et al, 2008; Nicolelis and Lebedev, 2009), the interaction between cortex and striatum (Opris et al, 2013) is also relevant. This is mainly because the striatum receives input from topographic projections (that are responsible for turning relevant behaviors on and off, depending on the behavioral context), from roughly 90% of the cortex (Bolam et al, 2000; Graybiel, 2004; DeLong and Wichmann, 2007).…”

Section: Introductionmentioning

confidence: 99%

Functional dynamics of primate cortico-striatal networks during volitional movements

Santos

Opriş

Hampson

et al. 2014

Front. Syst. Neurosci.

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The motor cortex and dorsal striatum (caudate nucleus and putamen) are key regions in motor processing but the interface between the cortex and striatum is not well understood. While dorsal striatum integrates information from multiple brain regions to shape motor learning and habit formation, the disruption of cortico-striatal circuits compromises the functionality of these circuits resulting in a multitude of neurologic disorders, including Parkinson's disease. To better understand the modulation of the cortico-striatal circuits we recorded simultaneously single neuron activity from four brain regions, primary motor, and sensory cortices, together with the rostral and caudal segments of the putamen in rhesus monkeys performing a visual motor task. Results show that spatial and temporal-task related firing relationships between these cortico-striatal circuit regions were modified by the independent administration of the two drugs (cocaine and baclofen). Spatial tuning and correlated firing of neurons from motor cortex and putamen were severely disrupted by cocaine and baclofen on correct trials, while the two drugs have dramatically decreased the functional connectivity of the motor cortical-striatal network. These findings provide insight into the modulation of cortical-striatal firing related to movement with implications for therapeutic approaches to Parkinson's disease and related disorders.

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A volunteer companion‐observer intervention reduces falls on an acute aged care ward

Abstract: This intervention used an inexpensive, human resources-based approach to significantly reduce the incidence of falls in the population at highest risk of falling. The additional benefits to patients in terms of cognitive improvement bear further investigation.

Cited by 41 publications

References 11 publications

The Role of Sitters in Delirium: an Update

The Role of Sitters in Delirium: an Update

Registered Nurses' Job Demands in Relation to Sitter Use

Functional dynamics of primate cortico-striatal networks during volitional movements

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