Measure, Promote, and Reward Mobility to Prevent Falls in Older Patients

Sinha, Samir K.; Detsky, Allan S.

doi:10.1001/jama.2012.68313

Cited by 19 publications

(5 citation statements)

References 8 publications

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“…In an editorial, geriatrics nurse expert Kagan () suggests that the discourse of falls prevention assumes no falls is good and that this paradoxically reduces activity. Lack of activity is recognised as a trigger for a range of complications in older hospitalised patients (Pedone et al, ; Thornlow, Anderson, & Oddone, ). Like Sinha and Detsky (), shifting the discourse from falls prevention to safe mobilisation may assist with promoting ambulation in older people with cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

Caring for the older person with cognitive impairment in hospital: Qualitative analysis of nursing personnel reflections on fall events

Grealish

Chaboyer

Darch

et al. 2019

Journal of Clinical Nursing

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Aims and objectives:To explore nurse and nursing assistant reflections on the care of older patients with cognitive impairment who have experienced a fall.Background: While there are evidence-based clinical guidelines for the prevention and management of falls and for the care of older people with cognitive impairment, the falls rates for older people with cognitive impairment are three times as high as those without. Design: Critical incident technique.Methods: Eleven registered and two enrolled nurses and four assistants in nursing working in one subacute and two acute wards within two hospitals of a tertiary level health service in south-east Queensland. Individual semistructured interviews focused on two past events when a patient with cognitive impairment had fallen in hospital: one when there was minimal harm and the second when there was significant harm. Thematic analysis was undertaken. The COREQ checklist was followed.Results: Three themes emerged from 23 reflective accounts of fall events: "direct observation is confounded by multiple observers" and "knowing the person has cognitive impairment is not enough," and "want to rely on the guideline but unsure how to enact it." While participants were aware of the falls prevention policy and techniques available to prevent falls, the implementation of these was challenging due to the complexity of care required by the older person with cognitive impairment. Conclusions:Falls prevention for older people with cognitive impairment is complex and belies the simple application of policy. Relevance to clinical practice:To reduce falls, nurses can involve the family to support "knowing the patient" to enable prediction of impulsive actions; shift the focus of in-service from lectures to specific case presentations, with collaborative analysis on personfocused strategies to prevent falls in older people with cognitive impairment; and reconsider the sitter role from simple observer to assistant, focused on ambulation and supporting independence in activities of daily living. K E Y W O R D Sdementia, falls, hospitalised patients, older patients, patient safety | 1347 GREALISH Et AL.

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Section: Discussionmentioning

confidence: 99%

Caring for the older person with cognitive impairment in hospital: Qualitative analysis of nursing personnel reflections on fall events

Grealish

Chaboyer

Darch

et al. 2019

Journal of Clinical Nursing

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“…a follow up phone call) may help keep patients committed to carrying out their exercises. [4][5][6]11,23 General physical exercise can also be viewed as type of priming for the nervous system to learn. Physical activity can improve cardiopulmonary dysfunction, metabolism, oxygen delivery, weakness, inflexibility, edema and degenerative joints.…”

Section: Introductionmentioning

confidence: 99%

A Review and Perspective on Maximizing Brain Plasticity: Priming the Nervous System to Learn

Byl¹

2017

IPMRJ

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Although we know the central nervous system is adaptable and can respond to learning based behavioral training to recover from trauma, disease or aging, in the clinic the effectiveness of recovery can be limited. Part of this limitation in recovery is due to the severity of the brain insult but part of this incomplete recovery is due to the conditions surrounding the individual patient that may need to be addressed to maximize plasticity. In this brief review, a perspective on the need to prime the nervous system to learn is provided for consideration and reflection.

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Section: Introductionmentioning

confidence: 99%

“…Approximately 30% of people over 65 years tend to fall each year, and up to 50% of these falls are recurrent. Falls result in increased morbidity, hospital costs, and worse mortality outcomes for elderly patients [1][2][3][4][5][6][7] Fall is a common geriatric syndrome that has not been well characterized in HIV-infected populations until recently. Fall risk increases as patients' age, and non HIV-infected populations have been related to the presence of multiple comorbidities, polypharmacy, and functional impairment.…”

Section: Introductionmentioning

confidence: 99%