Search results for ‘Subject term:"older people"’ Sort:
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Organising preventative care for the elderly: six alternative strategies
- Author:
- TAYLOR R.C.
- Publisher:
- (Health Bulletin vol.46 no.2 March 1988 pp87-92)
- Publication year:
- 1988
- Pagination:
- 6p.
- Place of publication:
- ?
Discusses six methods of screening and case-finding in elderly patients.
Do antipsychotics prevent postoperative delirium? a systematic review and meta-analysis
- Authors:
- FOK Mark C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(4), 2015, pp.333-344.
- Publisher:
- Wiley
Objective: To summarise the effect of antipsychotics for preventing postoperative delirium. Design: The authors conducted a literature search using Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and clinicaltrials.gov. Included wererandomized controlled trials of adults undergoing surgery who were given antipsychotics to prevent postoperative delirium. Quality was assessed via the Cochrane risk of bias tool. Random-effects meta-analysis and meta-regression were conducted. Q-statistics and I2 were used for assessment of heterogeneity. The main outcome was delirium incidence using validated definitions. Results: A total of 1710 subjects were included, with a mean age ranging from 60.7 to 86.4 years. Antipsychotics reduced the incidence of postoperative delirium with the global effect-size estimate (weighted odds ratio) using the random effects model of 0.44 (95% confidence interval: 0.28-0.70; N=6; Q-value: 16, p-value 0.0005; I2=69%). Significant heterogeneity existed with the pooled global effect of delirium incidence; however, meta-regression allowed us to test both treatment-level and patient-level explanations for significant between-study variance. Baseline risk for delirium was found to be a significant contributor to study heterogeneity, and meta-regression suggested that antipsychotic type and dosage were two of the several treatment-level factors that also may have led to heterogeneity. The analysis implied the presence of a breakeven baseline level of delirium risk below which preventive treatment with antipsychotics might prove ineffective. Conclusions: Within the limits of few randomized controlled trials, antipsychotics appeared to reduce the incidence of postoperative delirium in several surgical settings, predominantly orthopedic and for those at higher risk for delirium (Publisher abstract)
Taking a firm stand
- Author:
- MOONEY Helen
- Journal article citation:
- Health Service Journal, 27.5.10, 2010, pp.22-23.
- Publisher:
- Emap Healthcare
The problem of patients who fall in hospital settings such as acute hospitals, mental health trust units and community hospitals is discussed. The article highlights the importance of involving all professionals from across disciplines to address the problem. It also highlights the guide 'The 'how to' guide for reducing harm from falls' published by Patient Safety First. Statistics detailing the number of falls in hospital locations are also presented.
Cluster randomised trial of a targeted multifactorial intervention to prevent falls among older people in hospital
- Authors:
- CUMMING Robert G., et al
- Journal article citation:
- British Medical Journal, 5.4.08, 2008, pp.758-760.
- Publisher:
- British Medical Association
This Australian study aimed to determine the efficacy of a targeted multifactorial falls prevention programme in elderly care wards with relatively short lengths of stay. Participants were 3,999 patients, mean age of 79 years, with a median hospital stay of seven days. Participants were from 24 elderly care wards in 12 hospitals in Sydney, Australia. A nurse and physiotherapist each worked for 25 hours a week for three months in all intervention wards. They provided a targeted multifactorial intervention that included a risk assessment of falls, staff and patient education, drug review, modification of bedside and ward environments, an exercise programme, and alarms for selected patients. The main outcome measure used was falls during hospital stay. Results found intervention and control wards were similar at baseline for previous rates of falls and individual patient characteristics. Overall, 381 falls occurred during the study. No difference was found in fall rates during follow-up between intervention and control wards: respectively, 9.26 falls per 1,000 bed days and 9.20 falls per 1000 bed days. The incidence rate ratio adjusted for individual lengths of stay and previous fall rates in the ward was 0.96 (95% confidence interval 0.72 to 1.28). A targeted multifactorial falls prevention programme was not effective among older people in hospital wards with relatively short lengths of stay.
Falls in older people: QS86
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2017
- Place of publication:
- London
Updated NICE quality standard which sets out best practice for health and social care professionals in preventing falls in older people and assessing older people after a fall. The standard covers older people who are living in the community or staying in hospital. It includes eight quality statements, which cover: identifying older people at risk; multifactorial risk assessment and intervention; checking for injury after an inpatient fall; moving people safely after a fall; strength and balance training, and home hazard assessment and intervention. It highlights the value of health and social care practitioners asking questions about falls during routine appointments to identify older people most at risk and the importance of offering multifactoral falls risk assessment to help to prevent falls, disability and loss of independence. It updates the previous quality standard which was published in 2015. (Edited publisher abstract)
Does integrated governance lead to integrated patient care? Findings from the innovation forum
- Authors:
- BEECH Roger, et al
- Journal article citation:
- Health and Social Care in the Community, 21(6), 2013, pp.598-605.
- Publisher:
- Wiley
Good integration of services that aim to reduce avoidable acute hospital bed use by older people requires frontline staff to be aware of service options and access them in a timely manner. In three localities where closer inter-organisational integration was taking place, this research sought patients’ perceptions of the care received across and within organisational boundaries. Between February and July 2008, qualitative methods were used to map the care journeys of 18 patients (six from each site). Patient interviews (46) covered care received before, at the time of and following a health crisis. Additional interviews (66) were undertaken with carers and frontline staff. Grounded theory-based approaches showed examples of well-integrated care against a background of underuse of services for preventing health crises and a reliance on ‘traditional’ referral patterns and services at the time of a health crisis. There was scope to raise both practitioner and patient awareness of alternative care options and to expand the availability and visibility of care ‘closer to home’ services such as rapid response teams. Concerns voiced by patients centred on the adequacy of arrangements for organising ongoing care, while family members reported being excluded from discussions about care arrangements and the roles they were expected to play. The coordination of care was also affected by communication difficulties between practitioners (particularly across organisational boundaries) and a lack of compatible technologies to facilitate information sharing. Finally, closer organisational integration seemed to have limited impact on care at the patient/practitioner interface. To improve care experienced by patients, organisational integration needs to be coupled with vertical integration within organisations to ensure that strategic goals influence the actions of frontline staff. As they experience the complete care journey, feedback from patients can play an important role in the service redesign agenda. (Publisher abstract)
Avoiding systemic neglect and abuse in older people's inpatient mental health care settings
- Author:
- MINSHULL Phil
- Journal article citation:
- Journal of Adult Protection, 6(4), December 2004, pp.27-32.
- Publisher:
- Emerald
Suggests that models can be set in place to prevent neglect and abuse in in-patient settings from becoming systemic, describing how the establishment of multi-agency forums within care teams can help foster working practices that are open, accountable and respectful.
Hospital to a Healthier Home: evaluation of a winter pressures pilot service
- Author:
- CARE AND REPAIR CYMRU
- Publisher:
- Care and Repair Cymru
- Publication year:
- 2019
- Pagination:
- 36
- Place of publication:
- Cardiff
An evaluation of the Hospital to a Healthier Home pilot scheme, delivered by Care and Repair, which ran from 11 hospitals between January and March 2019. The scheme aimed to support older people to be safely and more quickly discharged from hospitals to their homes and prevent them being re-admitted by making their homes safe and more accessible. This evaluation describes how the Hospital to a Health Home case worker service started, what type of interventions have been provided to patients and hospital staff, costs, benefits and the difference it has made to patient well-being, quicker safe discharges, and preventing re-admissions. The pilot involved dedicated Care and Repair case workers based at each hospital to facilitate practical improvements to a patient’s home and offer practical support on issues such as benefits entitlements. During the evaluation period: 626 patients were referred through Hospital to a Healthier Home service; 508 patients received work that helped quicker safe discharge. Based on a local assessment of bed day savings, the evaluation found that service costs are fully substantiated, and return £2.80 for every £1 invested (both revenue and capital). NHS frontline staff interviewed for the evaluation study also felt the service was of significant benefit and had the potential to deliver more. (Edited publisher abstract)
Do occupational therapists and physiotherapists teach elderly people: how to rise after a fall
- Authors:
- KINN Sue, GALLOWAY Linda
- Journal article citation:
- British Journal of Occupational Therapy, 63(6), June 2000, pp.254-259.
- Publisher:
- Sage
Falling is a major problem for the elderly population and much research has been done to investigate the risk factors for and means of preventing falls. This postal survey was undertaken to investigate whether therapists do anything to try to prevent falls, assess elderly people for suitability and teach them how to rise after a fall. The results showed that almost all the respondents (127 of 137) identified falling as a problem that they had to deal with in their patients over 65 years. Over half the respondents had considered teaching people how to rise after a fall. A range of different methods was used, which broadly fell into physical and verbal instructions or referral to other health care professionals.
Improving the health of older Londoners: reviewing the evidence
- Authors:
- HOWSE Kenneth, PROPHET Helen
- Publisher:
- Centre for Policy on Ageing
- Publication year:
- 2000
- Pagination:
- 111p.,tables,bibliog.
- Place of publication:
- London
Reviews the literature on the scope for improving the health of older people, particularly Londoners, in the context of the policy goals of the prevention of ill-health and disability, and the preservation of independence in later life. Identifies the key issues in developing a relevant strategy, summarises the epidemiology, reviews the evidence on the effectiveness of interventions, and discusses policy options.