Tag Archives: Accidental Falls

What are some current fall prevention interventions for hospitalized patients?

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“Despite decades of fall prevention efforts, patient falls remain a common cause of harm in hospitalized older adults. While fall prevention strategies have been historically championed by nurses, hospitalist physicians, nurse practitioners, and physician assistants play a vital role in the multidisciplinary care team in ensuring the safety of our patients. Promising strategies for fall prevention include tailoring interventions to patient risk factors and individualized patient education. In addition to nursing-based interventions, the hospitalist’s role in fall prevention is to (1) identify and address potentially modifiable risk factors, (2) reinforce individualized education to patients, and (3) advise behavior choices that promote safe mobility.”

Keuseman, R., & Miller, D. (2020). A hospitalist’s role in preventing patient falls. Hospital Practice : Advances in Medicine for Primary Care Physicians.,48(Sup1), 63-67.
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Falls prevention and mobility promotion

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These articles are about falls prevention and mobility promotion. Non-hospitalized adults are included to maximize the number of helpful articles.
Two noteworthy articles

 

Growdon ME, Shorr RI, Inouye SK. The tension between promoting mobility and preventing falls in the hospital. JAMA Intern Med. 2017 Jun 1;177(6):759-760. doi: 10.1001/jamainternmed.2017.0840.

Sinha SK, Detsky AS. Measure, promote, and reward mobility to prevent falls in older patients. JAMA. 2012 Dec 26;308(24):2573-4. doi: 10.1001/jama.2012.68313. No abstract available.

Here’s how to access the full collection of 14 items in PubMed.

a. Go to the Woodruff Health Sciences Center Library homepage (http://health.library.emory.edu)
b. Click on PubMed.
c. Then paste the following link into your browser:
https://www.ncbi.nlm.nih.gov/sites/myncbi/1HMKnKhQm_d5i/collections/58770766/public/
d. The references will appear in PubMed. Click on a reference and you will see a Find it at Emory on the right side of the page which will provide links to full text within Emory University’s licensed resources. Emory Healthcare staff may send citations of needed articles they are unable to access to Ask a Librarian; a library staff person will request the article(s) from an outside library and email them to the EHC staff person upon arrival.

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Important message for Emory Decatur Nurses. The links will not work for you. To access these articles contact the Emory Decatur Library:

Emory Decatur Hospital
Jessica Callaway (Jessica.callaway@emoryhealthcare.org
404.501.1628

Literature on fall reduction, specifically in the cognitively/neurologically impaired

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Medical Education & Technologies Informationist searched PubMed with some of these following terms: cognitive function, cognitive impairment, nervous system disease, neurological impairment, and accident falls/prevention.

You can see the full search here.

Below are some of the articles that were found with the search.

Lipardo DS, Aseron AMC, Kwan MM, Tsang WW. Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review. Arch Phys Med Rehabil. 2017Oct;98(10):2079-2096. doi: 10.1016/j.apmr.2017.04.021. Epub 2017 May 26. Review.
PubMed PMID: 28554873. Full text

Jensen L, Padilla R. Effectiveness of Environment-Based Interventions That Address Behavior, Perception, and Falls in People With Alzheimer’s Disease and Related Major Neurocognitive Disorders: A Systematic Review. Am J Occup Ther. 2017 Sep/Oct;71(5):7105180030p1-7105180030p10. doi: 10.5014/ajot.2017.027409. PubMed PMID: 28809653.

Lach HW, Harrison BE, Phongphanngam S. Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review. Res Gerontol Nurs. 2017
May 1;10(3):139-148. doi: 10.3928/19404921-20160908-01. Epub 2016 Sep 23. Review. PubMed PMID: 27665756.

Rushton C. Problematising the problem: a critical interpretive review of the literature pertaining to older people with cognitive impairment who fall while hospitalised. Nurs Inq. 2016 Jun;23(2):148-57. doi: 10.1111/nin.12126. Epub 2016 Feb 2. Review. PubMed PMID: 26833849.

Gunn H, Markevics S, Haas B, Marsden J, Freeman J. Systematic Review: The Effectiveness of Interventions to Reduce Falls and Improve Balance in Adults With Multiple Sclerosis. Arch Phys Med Rehabil. 2015 Oct;96(10):1898-912. doi: 10.1016/j.apmr.2015.05.018. Epub 2015 Jun 10. Review. PubMed PMID: 26070975. Full text

Bhidayasiri R, Jitkritsadakul O, Boonrod N, Sringean J, Calne SM, Hattori N, Hayashi A. What is the evidence to support home environmental adaptation in Parkinson’s disease? A call for multidisciplinary interventions. Parkinsonism Relat Disord. 2015 Oct;21(10):1127-32. doi: 10.1016/j.parkreldis.2015.08.025. Epub 2015 Aug 25. Review. PubMed PMID: 26365779. Full text

Booth V, Hood V, Kearney F. Interventions incorporating physical and cognitive elements to reduce falls risk in cognitively impaired older adults: a systematic review protocol. JBI Database System Rev Implement Rep. 2015 Sep 16;13(8):5-13. doi: 10.11124/jbisrir-2015-2220. Review. PubMed PMID: 26455930. Full text

Sosnoff JJ, Sung J. Reducing falls and improving mobility in multiple sclerosis. Expert Rev Neurother. 2015 Jun;15(6):655-66. doi: 10.1586/14737175.2015.1046377. Epub 2015 May 14. Review. PubMed PMID: 25973774.

Burton E, Cavalheri V, Adams R, Browne CO, Bovery-Spencer P, Fenton AM, Campbell BW, Hill KD. Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clin Interv Aging. 2015 Feb 9;10:421-34. doi: 10.2147/CIA.S71691. eCollection 2015. Review. PubMed PMID: 25709416; PubMed Central PMCID: PMC4330004. Full text

Chan WC, Yeung JW, Wong CS, Lam LC, Chung KF, Luk JK, Lee JS, Law AC. Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis. J Am Med Dir Assoc. 2015 Feb;16(2):149-54. doi: 10.1016/j.jamda.2014.08.007. Epub 2014 Oct 7. Review. PubMed PMID: 25304179. Full text

Ayoubi F, Launay CP, Annweiler C, Beauchet O. Fear of falling and gait variability in older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2015 Jan;16(1):14-9. doi: 10.1016/j.jamda.2014.06.020. Epub 2014 Sep 16. Review. PubMed PMID: 25230892. Full text

Guo JL, Tsai YY, Liao JY, Tu HM, Huang CM. Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta-analysis. Int J Geriatr Psychiatry. 2014 Jul;29(7):661-9. doi: 10.1002/gps.4056. Epub 2013 Dec 7. Review. PubMed PMID: 24318959.

EHC staff may request full text of articles for which links to full text are not provided above via Ask a Librarian.

MW email to MedRef patron, 2/1/18

Post-falls assessment tools to help in post-fall decision making in acute care settings

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Joanna Briggs Institute (JBI) has a recommended practice entitled “Observation Following Falls in Acute Care: Older People” that is available via login with your Emory Healthcare login; search for the document by title in JBI, click “Display Results,” and then click “JBI Database PDF”: http://pid.emory.edu/h78zp

There are a variety of relevant post-falls assessment tools online:
1. Royal Devon Exeter National Health Service Foundation Trust pdf: https://tinyurl.com/yansp8t4
2. Intermountain Healthcare pdf: https://tinyurl.com/ydgxar6n
3. A Veterans Affairs Word document: https://tinyurl.com/ybvfoq2z
4. Ohio State University Medical Center pdf: https://tinyurl.com/y6usjgk8
5. South Western Ambulance Service National Health Service pdf: https://tinyurl.com/y8xqoxod

Please follow these instructions to access 8 relevant articles in PubMed.

a. Go to the Woodruff Health Sciences Center Library homepage (http://health.library.emory.edu)
b. Click on PubMed.
c. Then copy and paste this link into your browser address bar: https://www.ncbi.nlm.nih.gov/sites/myncbi/1HMKnKhQm_d5i/collections/52782984/public/
d. The references will appear in  PubMed. Click on a reference, and you will see a Find it at Emory to the right of it which will provide availability for full text. If you are not able to access full text, you may submit citation(s) to Ask a Librarian. Library staff will get article(s) for you and email them to you.

Improvement in falls rate and prevention of falls on the surgical floor

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Here is how to access 22 references on improvement in falls rate and prevention of falls on the surgical floor.
Go to Woodruff Health Sciences Center (WHSC) Library webpage: http://health.library.emory.edu
Click on PubMed.
Paste this url into your browser: https://www.ncbi.nlm.nih.gov/sites/myncbi/1HuA1sy0j55QI/collections/52512629/public/

Fall Prevention and Injury Reduction

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The following search was performed in PubMed. Copy and paste into PubMed search box to run.

(“accidental falls/prevention and control”[MAJOR] OR “Wounds and Injuries/prevention and control”[MAJOR]) AND (“hospitalization”[MAJOR] OR hospitaliz*[TW] OR “inpatients”[MAJOR]) AND English[lang] AND systematic[sb]

Selected relevant studies

1. Effectiveness of the use of bedrails in preventing falls among hospitalized older adults: a systematic review protocol. Marques P, Queirós C, Apóstolo J, Cardoso D.
JBI Database System Rev Implement Rep. 2015 Jul 17;13(6):4-15. doi: 10.11124/jbisrir-2015-2116. Review. No abstract available.
PMID: 26455740

2. Efficacy of falls prevention interventions: protocol for a systematic review and network meta-analysis.
Tricco AC, Cogo E, Holroyd-Leduc J, Sibley KM, Feldman F, Kerr G, Majumdar SR, Jaglal S, Straus SE.
Syst Rev. 2013 Jun 6;2:38. doi: 10.1186/2046-4053-2-38.
PMID: 23738619 Free PMC Article

3. Creation of a multi-interventional fall-prevention program: using evidence-based practice to identify high-risk units and tailor interventions. Lloyd T.
Orthop Nurs. 2011 Jul-Aug;30(4):249-57; quiz 258-9. doi: 10.1097/NOR.0b013e3182247c61.
PMID: 21799380

4. Reducing fall risk in the elderly: risk factors and fall prevention, a systematic review.
Pfortmueller CA, Lindner G, Exadaktylos AK.
Minerva Med. 2014 Aug;105(4):275-81. Epub 2014 May 27. Review.
PMID: 24867188 (Request through Ask A Librarian)

5. Meta-analysis: multidisciplinary fall prevention strategies in the acute care inpatient population.
DiBardino D, Cohen ER, Didwania A.
J Hosp Med. 2012 Jul-Aug;7(6):497-503. doi: 10.1002/jhm.1917. Epub 2012 Feb 27. Review.
PMID: 22371369 (Can be ordered for you)
6. Fall prevention in hospitals: an integrative review. Spoelstra SL, Given BA, Given CW.
Clin Nurs Res. 2012 Feb;21(1):92-112. doi: 10.1177/1054773811418106. Epub 2011 Aug 23. Review. Erratum in: Clin Nurs Res. 2012 May;21(2):243.
PMID: 21862700 (Request through Ask A Librarian)

7. Prevention of falls and fall related injuries in older people in nursing homes and hospitals.
Handoll H. Inj Prev. 2010 Apr;16(2):137-8. doi: 10.1136/ip.2010.026625. No abstract available.
PMID: 20363823 (Request through Ask A Librarian)

Falls prevention in acute care

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Searched PubMed for the concepts of falls, falls prevention, acute care, protocol

Searched Joanna Briggs for falls prevention and acute care.

Morello, R., Barker, A., Zavarsek, S., Watts, J., Haines, T., Hill, K., . . . Stoelwinder, J. (n.d.). The 6-PACK programme to decrease falls and fall-related injuries in acute hospitals: Protocol for an economic evaluation alongside a cluster randomised controlled trial. IP Online : Injury Prevention., 18(2), E2.

Heaton, C. (n.d.). Creating a protocol to reduce inpatient falls. Nursing times : NT., 108(12), 16-18.

Barker, A., Brand, C., Haines, T., Hill, K., Brauer, S., Jolley, D., . . . Kamar, J. (n.d.). The 6-PACK programme to decrease fall-related injuries in acute hospitals: Protocol for a cluster randomised controlled trial. IP Online : Injury Prevention., 17(4), E5.

Courtney, M., Edwards, H., Chang, A., Parker, A., Finlayson, K., & Hamilton, K. (2011). A randomised controlled trial to prevent hospital readmissions and loss of functional ability in high risk older adults: A study protocol. BMC Health Services Research, 11, 202.

Aranda-Gallardo, M., Enriquez de Luna-Rodriguez, M., Canca-Sanchez, J., Moya-Suarez, A., & Morales-Asencio, J. (n.d.). Validation of the STRATIFY falls risk-assessment tool for acute-care hospital patients and nursing home residents: Study protocol. Journal of Advanced Nursing., 71(8), 1948-1957.

Tricco, A., Cogo, E., Holroyd-Leduc, J., Sibley, K., Feldman, F., Kerr, G., . . . Straus, S. (2013). Efficacy of falls prevention interventions: Protocol for a systematic review and network meta-analysis. Systematic Reviews, 2, 38.

Lizarondo, Lucylynn [PhD, MPhysio, MPsych, BPhysio]. Fall Assessment and Intervention: Acute Care Setting.
[Evidence Summaries] 2016

Lizarondo, Lucylynn [PhD, MPhysio, MPsych, BPhysio]. Fall Assessment and Intervention: Acute Care Setting.
[Evidence Summaries] 2016