Evaluation of the effect of patient education on rates of falls in older hospital patients: Description of a randomised controlled trial

Background. Accidental falls by older patients in hospital are one of the most commonly reported adverse events. Falls after discharge are also common. These falls have enormous physical, psychological and social consequences for older patients, including serious physical injury and reduced quality of life, and are also a source of substantial cost to health systems worldwide. There have been a limited number of randomised controlled trials, mainly using multifactorial interventions, aiming to prevent older people falling whilst inpatients. Trials to date have produced conflicting results and recent meta-analyses highlight that there is still insufficient evidence to clearly identify which interventions may reduce the rate of falls, and falls related injuries, in this population. Methods and design. A prospective randomised controlled trial (n = 1206) is being conducted at two hospitals in Australia. Patients are eligible to be included in the trial if they are over 60 years of age and they, or their family or guardian, give written consent. Participants are randomised into three groups. The control group continues to receive usual care. Both intervention groups receive a specifically designed patient education intervention on minimising falls in addition to usual care. The education is delivered by Digital Video Disc (DVD) and written workbook and aims to promote falls prevention activities by participants. One of the intervention groups also receives follow up education training visits by a health professional. Blinded assessors conduct baseline and discharge assessments and follow up participants for 6 months after discharge. The primary outcome measure is falls by participants in hospital. Secondary outcome measures include falls at home after discharge, knowledge of falls prevention strategies and motivation to engage in falls prevention activities after discharge. All analyses will be based on intention to treat principle. Discussion. This trial will examine the effect of a single intervention (specifically designed patient education) on rates of falls in older patients in hospital and after discharge. The results will provide robust recommendations for clinicians and researchers about the role of patient education in this population. The study has the potential to identify a new intervention that may reduce rates of falls in older hospital patients and could be readily duplicated and applied in a wide range of clinical settings. Trial Registration. ACTRN12608000015347

Factors influencing nurses' compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study

<p>Abstract</p> <p>Background</p> <p>Nurses may acquire an infection during the provision of nursing care because of occupational exposure to microorganisms. Relevant literature reports that, compliance with Standard Precautions (a set of guidelines that can protect health care professionals from being exposed to microorganisms) is low among nurses. Additionally, high rates of exposure to microorganisms among nurses via several modes (needlesticks, hand contamination with blood, exposure to air-transmitted microorganisms) occur. The aim of the study was to study the factors that influence nurses' compliance with Standard Precaution in order to avoid occupational exposure to pathogens, by employing a qualitative research design.</p> <p>Method</p> <p>A focus group approach was used to explore the issue under study. Four focus groups (N = 30) were organised to elicit nurses' perception of the factors that influence their compliance with Standard Precautions. The Health Belief Model (HBM) was used as the theoretical framework and the data were analysed according to predetermined criteria.</p> <p>Results</p> <p>Following content analysis, factors that influence nurses' compliance emerged. Most factors could be applied to one of the main domains of the HBM: benefits, barriers, severity, susceptibility, cues to action, and self-efficacy.</p> <p>Conclusions</p> <p>Changing current behavior requires knowledge of the factors that may influence nurses' compliance with Standard Precautions. This knowledge will facilitate in the implementation of programs and preventive actions that contribute in avoiding of occupational exposure.</p

The effect of safety education based on Health Belief Model (HBM) on the workers practice of Borujen industrial town in using the personal protection respiratory equipments

Background and aims  &nbsp;Every year 50-158 million occupational diseases and job accidents occur in the world. Studies on the job injuries show that about 150000 injuries occur annually in  Iran. Unhealthy behaviors are important problems in public health. Education is one of the best ways to change unhealthy behaviors. Interventions based on model and theories have many  capacities for behavior change. Health Belief Model is one of the health education models that are  useful for behavior change. This research has been performed in order to assess the effect of health  education program based on health belief model (HBM) to prevent occupational respiratory   diseases in workers.   Methods   Aquasi-experimental design was used for this interventional study, in which 88 of workers of Borujen industrial town participated, who were randomly assigned to experimental and control group. Data collecting tool were a self-administered questionnaire including 53 questions based on health belief model that was completed by the workers, in addition to the performance check list which was conducted by researcher via insensible controlling the workers' safety behaviour. Validity and reliability of the tools were examined prior to the study. Educational  intervention was conducted in the first stage following by the second data collection one month  later. The data of both experimental and control group were compared statistically before and  after the intervention.   Results  &nbsp;The results showed that the mean of the grade of all parts of health belief model  (HBM) and performance mark of the workers about safety and use of personal respiratory  preventive equipment in experimental group after educational intervention compared to prior the  study and also compared to control group were significantly increased.   Conclusion   The results of this survey showed that by enhancement of health belief model (HBM) components including perceived susceptibility, perceived severity, perceived barriers  and perceived benefits, adopting preventive actions increases, too. Therefore, the results of this survey confirm the effectiveness and efficiency of health belief model (HBM) in safety education and adopting preventive actions of respiratory occupational diseases in worker's behaviors

Awareness of osteoporosis among female head of household : an Iranian experience

Summary: More than 81 of the studied women had a poor knowledge of different aspects of osteoporosis and its complications, suggesting that more educational programs targeting women in particular are needed to help improve the osteoporosis practice in the societies and reduce the burden of the disease. Purpose: The family structure has changed considerably in the past decade. But, women from Iran and many countries in the region and even families with similar cultural background living in other parts of the world are still responsible for childcare as well as the lifestyle adapted by the family. The present study was conducted to assess the awareness of the female head of household of osteoporosis and its complications. Methods: As part of a population-based study in two Iranian cities, Arak and Sannandaj, to study osteoporosis and its risk factors, a questionnaire on the knowledge of female head of households of osteoporosis and its complications was completed. The subsample filled out the knowledge survey along with the questionnaire on their demographic data, socioeconomic status (SES), reproductive factors, bone-related lifestyle habits, family and personal medical history, medication use, and compliance with osteoporosis medication (if used) as well as a FFQ filled out for all the 2100 participants. They also underwent a bone mineral density (BMD) test, and their serum levels of vitamin D were calculated. These data were then used to assess the factors affecting their awareness level. Results: The knowledge of 81.3 (473) of the studied women was found to be poor on different aspects of osteoporosis and its complications. Multivariate analysis revealed that each level increase in vit D intake tertile increases the chance of higher awareness level in K-Total by 1.5 times. Each level increase in physical activity tertile was associated with a 30.6 lower chance of having a good knowledge. Conclusion: Considering the poor awareness level of the studied women and their poor practice of bone healthy behavior, one could conclude that more programs are needed or the content/delivery style of the existing ones should be optimized. © 2017, International Osteoporosis Foundation and National Osteoporosis Foundation