Fall prevention intervention technologies: A conceptual framework and survey of the state of the art

In recent years, an ever increasing range of technology-based applications have been developed with the goal of assisting in the delivery of more effective and efficient fall prevention interventions. Whilst there have been a number of studies that have surveyed technologies for a particular sub-domain of fall prevention, there is no existing research which surveys the full spectrum of falls prevention interventions and characterises the range of technologies that have augmented this landscape. This study presents a conceptual framework and survey of the state of the art of technology-based fall prevention systems which is derived from a systematic template analysis of studies presented in contemporary research literature. The framework proposes four broad categories of fall prevention intervention system: Pre-fall prevention; Post-fall prevention; Fall injury prevention; Cross-fall prevention. Other categories include, Application type, Technology deployment platform, Information sources, Deployment environment, User interface type, and Collaborative function. After presenting the conceptual framework, a detailed survey of the state of the art is presented as a function of the proposed framework. A number of research challenges emerge as a result of surveying the research literature, which include a need for: new systems that focus on overcoming extrinsic falls risk factors; systems that support the environmental risk assessment process; systems that enable patients and practitioners to develop more collaborative relationships and engage in shared decision making during falls risk assessment and prevention activities. In response to these challenges, recommendations and future research directions are proposed to overcome each respective challenge.The Royal Society, grant Ref: RG13082

Prevention of Falls Injury Trial (PreFIT) : multifactorial fall prevention manual [version 12]

This is the multifactorial falls prevention (MFFP) manual for the Prevention of Fall Injury Trial (PreFIT). This manual has been written and designed for health professionals involved in the delivery of falls prevention services to older persons participating in the PreFIT study. Some healthcare professionals will have considerable experience of working in falls services prevention and will be very familiar with the rationale for falls prevention, assessment procedures, definitions and recommended treatment pathways. However, not all those working from this manual will have the same level of background training and experience therefore the manual has been developed to account for differing levels of skill, training and clinical expertise. The aims of this MFFP manual are: To provide the scientific research evidence about the components within MFFP programmes and to describe the model selected for use in the Pre-FIT study; To explain the rationale for the chosen study design; To describe procedures for the assessment and treatment of trial participants who have been referred to MFFP services; To describe trial documentation and adverse event reporting procedures

Fall prevention in the community: what older people say they need

Original article can be found at: http://www.bjcn.co.uk/ Copyright MA HealthcareUptake of and adherence to fall prevention interventions is often poor and we know little about how older people’s perceptions of and beliefs about fall prevention interventions affect uptake. This study aimed to explore older people’s perceptions of the facilitators and barriers to participation in fall prevention interventions. We undertook a qualitative study with older people who had taken part in, declined to participate or adhere to fall prevention interventions using semi-structured interviews (n=65), and 17 focus groups (n=122) with older people (including 32 South Asian and 30 Chinese older people) in primary and community care settings in the South of England. A number of factors acted as either barriers or facilitators to uptake of interventions. Older people also made recommendations for improving access to interventions. Community nurses are ideally placed to screen older people, identify those at risk of falling and refer them to appropriate interventions as well as providing health promotion and education.Peer reviewe

Fall Prevention

Fall Prevention Abstract Background: According to the CDC, the medical cost for falls was approximately $30 billion in 2012. When a patient falls, and gets serious injury, these costs could sum up to$14,056 per patient. As a result, hospital stays per patient are observed to increase by approximately 6.3 days longer than those patients who haven’t encountered falls. This study focused on identifying high fall risk patients, and developing a plan of care to reduce the occurrence of falls in a hospital setting. Nurses using safe fall interventions techniques have been proven to inspire fall preventions. An assessment of the nursing practices in the microsystem was carried out to identify the barriers that affected the fall prevention and increased falls rates in the unit. This assessment showed an inconsistence in the placement of fall signs by the nursing staff. This discovery was critical to addressing the fall rates in the unit. Purpose: To execute and develop an effective and functional fall prevention plan with a goal to reduce inpatient fall rate by 25%. This should enhance the ability of nurses to comply when implementing fall procedures and using fall prevention equipment. Methods: This study employed the Kurt Lewin’s change model, which included developing a fall prevention committee, creating a new fall signage and continuous education of staff members. Results: The rate falls in the microsystem were observed to have declined significantly. Nursing staff are more compliant with the new fall prevention protocol

Fall prevention

During clinical shift at Baptist Health Paducah Hospital on the CCU floor the question asked was, what needs to be researched? After watching the charge nurse help patients all day I asked her what she thought needed to be researched. After thinking for a while she went on to tell me about how they are getting hit pretty hard on infections so there is no need for more research on that. After that she went on to tell me that their fall prevention protocol was lacking pretty badly. They do a fall risk assessment and based on the number decide what their chances of a fall is. They then give them fall risk bracelets and bed alarms. She said the bed alarms they have a pretty outdated and don’t work half the time they are used. There had to be newer research on better fall prevention. There protocol is lacking something that keeps the patients from not getting hurt. T It seems like it is just there for the nurse so they know that the patient is at risk for falling. This doesn’t help prevent a fall for the patient. Plus some nurses can’t get to the alarm right away so by the time they go to check the alarm it is too late. After doing some research a few articles about patient teaching and involving the patient in fall prevention popped up. The problem with the current policy is that it is lacking new evidence based practice

Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.Funding Agencies|Swedish Research Council [2015-03481]; Strategic Research Programme in Care Sciences, Umea University; Karolinska Institute, Sweden; Umea University</p

Patient Fall Prevention

PATIENT FALL PREVENTION STRATEGIES IN AN ACUTE HOSPITAL Every year in the United States, hundreds of thousands of patients fall resulting in injury. Injured patients often require prolonged hospital stays and a resultant increase in medical costs. The purpose of this study was to identify the current state of fall prevention strategies on a hospital inpatient acute care cardiac unit. Through a root cause analysis, some deficiencies were identified and a process improvement plan was implemented. Several positive outcomes were attained as a result of the countermeasures initiated. Patient falls per month and total waste in dollars saw a decline and, subsequently, an increase was realized in dollars saved in medical costs. It is hoped that this study will provide practitioners with additional tools to enhance current fall prevention programs

The Experience and Perception of Physiotherapists in Nigeria re: Fall Prevention in Recurrent-Faller Older Adults

Background: Effective fall prevention practices are essential for reducing falls among older adults. Rehabilitation professionals like physiotherapists are essential members of the fall prevention team, yet little is known about the experiences of physiotherapists practicing fall prevention in developing nations. Objective: To explore the experiences of physiotherapists in Nigeria who practice fall prevention among older adults. Method: We adopted a phenomenological approach to the traditional qualitative design in this study. We purposefully selected and conducted face-to-face interview with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data was analyzed using thematic analysis. Results: Four themes emerged from our participants: characteristics of recurrent fallers, fall prevention practices, hindrances to fall prevention, and strategies to promote fall prevention practices. In practice, understanding the characteristics (risk factors) of older adults with a history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls. Conclusion: This study adds to the sparse amount of literature concerning the experience of physiotherapist in fall prevention practices in the developing world. More importantly, the findings of this study will strengthen or stimulate discussion around development of fall prevention strategies specific to the developing world context

Interventions for fall prevention in community-dwelling older persons

Falls in individuals over the age of 65 is a pervasive problem resulting in significant health and economic burden in our country. Thus, effective fall prevention strategies are an important public health measure, especially in an age group that is growing rapidly. Research has shown a multifactorial approach to fall prevention addressing environmental hazards, strength and balance, medications, and medical comorbidities to be most effective. Despite there being strong evidence to support this, many individuals are unaware of the factors that put them at risk and ways to mitigate them. An educational pamphlet containing evidence-based strategies to reduce fall risk was produced for distribution within the New Milford primary care clinic in New Milford, CT.https://scholarworks.uvm.edu/fmclerk/1511/thumbnail.jp