[ { "key": "7FGVCEW2", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/7FGVCEW2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/7FGVCEW2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Gillespie et al.", "parsedDate": "2009", "numChildren": 0 }, "data": { "key": "7FGVCEW2", "version": 1, "itemType": "journalArticle", "title": "WITHDRAWN: Interventions for preventing falls in elderly people", "creators": [ { "creatorType": "author", "firstName": "Lesley D", "lastName": "Gillespie" }, { "creatorType": "author", "firstName": "William J", "lastName": "Gillespie" }, { "creatorType": "author", "firstName": "M Clare", "lastName": "Robertson" }, { "creatorType": "author", "firstName": "Sarah E", "lastName": "Lamb" }, { "creatorType": "author", "firstName": "Robert G", "lastName": "Cumming" }, { "creatorType": "author", "firstName": "Brian H", "lastName": "Rowe" } ], "abstractNote": "BACKGROUND: Approximately 30 per cent of people over 65 years of age and living in the community fall each year; the number is higher in institutions. Although less than one fall in 10 results in a fracture, a fifth of fall incidents require medical attention. OBJECTIVES: To assess the effects of interventions designed to reduce the incidence of falls in elderly people (living in the community, or in institutional or hospital care). SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (January 2003), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2003), MEDLINE (1966 to February 2003), EMBASE (1988 to 2003 Week 19), CINAHL (1982 to April 2003), The National Research Register, Issue 2, 2003, Current Controlled Trials (www.controlled-trials.com accessed 11 July 2003) and reference lists of articles. No language restrictions were applied. Further trials were identified by contact with researchers in the field. SELECTION CRITERIA: Randomised trials of interventions designed to minimise the effect of, or exposure to, risk factors for falling in elderly people. Main outcomes of interest were the number of fallers, or falls. Trials reporting only intermediate outcomes were excluded. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. Data were pooled using the fixed effect model where appropriate. MAIN RESULTS: Sixty two trials involving 21,668 people were included.Interventions likely to be beneficial:Multidisciplinary, multifactorial, health/environmental risk factor screening/intervention programmes in the community both for an unselected population of older people (4 trials, 1651 participants, pooled RR 0.73, 95%CI 0.63 to 0.85), and for older people with a history of falling or selected because of known risk factors (5 trials, 1176 participants, pooled RR 0.86, 95%CI 0.76 to 0.98), and in residential care facilities (1 trial, 439 participants, cluster-adjusted incidence rate ratio 0.60, 95%CI 0.50 to 0.73) A programme of muscle strengthening and balance retraining, individually prescribed at home by a trained health professional (3 trials, 566 participants, pooled relative risk (RR) 0.80, 95% confidence interval (95%CI) 0.66 to 0.98) Home hazard assessment and modification that is professionally prescribed for older people with a history of falling (3 trials, 374 participants, RR 0.66, 95% CI 0.54 to 0.81) Withdrawal of psychotropic medication (1 trial, 93 participants, relative hazard 0.34, 95%CI 0.16 to 0.74) Cardiac pacing for fallers with cardioinhibitory carotid sinus hypersensitivity (1 trial, 175 participants, WMD -5.20, 95%CI -9.40 to -1.00) A 15 week Tai Chi group exercise intervention (1 trial, 200 participants, risk ratio 0.51, 95%CI 0.36 to 0.73). Interventions of unknown effectiveness:Group-delivered exercise interventions (9 trials, 1387 participants) Individual lower limb strength training (1 trial, 222 participants) Nutritional supplementation (1 trial, 46 participants) Vitamin D supplementation, with or without calcium (3 trials, 461 participants) Home hazard modification in association with advice on optimising medication (1 trial, 658 participants), or in association with an education package on exercise and reducing fall risk (1 trial, 3182 participants) Pharmacological therapy (raubasine-dihydroergocristine, 1 trial, 95 participants) Interventions using a cognitive/behavioural approach alone (2 trials, 145 participants) Home hazard modification for older people without a history of falling (1 trial, 530 participants) Hormone replacement therapy (1 trial, 116 participants) Correction of visual deficiency (1 trial, 276 participants).Interventions unlikely to be beneficial:Brisk walking in women with an upper limb fracture in the previous two years (1 trial, 165 participants). AUTHORS' CONCLUSIONS: Interventions to prevent falls that are likely to be effective are now available; less is known about their effectiveness in preventing fall-related injuries. Costs per fall prevented have been established for four of the interventions and careful economic modelling in the context of the local healthcare system is important. Some potential interventions are of unknown effectiveness and further research is indicated.", "publicationTitle": "Cochrane Database of Systematic Reviews (Online)", "publisher": "", "place": "", "date": "2009", "volume": "", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "CD000340", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Cochrane Database Syst Rev", "DOI": "10.1002/14651858.CD000340.pub2", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19370556", "accessDate": "2009-07-12T15:59:10Z", "PMID": "", "PMCID": "", "ISSN": "1469-493X", "archive": "", "archiveLocation": "", "shortTitle": "WITHDRAWN", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19370556", "tags": [ { "tag": "Accidents, Home", "type": 1 }, { "tag": "Environment Design", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Patient Education as Topic", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "KRWRK4QD", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/KRWRK4QD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/KRWRK4QD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Centers for Disease Control and Prevention (CDC)", "numChildren": 0 }, "data": { "key": "KRWRK4QD", "version": 1, "itemType": "webpage", "title": "WISQARS (Web-based Injury Statistics Query and Reporting System)", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "Centers for Disease Control and Prevention (CDC)" } ], "abstractNote": "Provides customized reports of injury-related data from the National Center of Health Statistics (NCHS)", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.cdc.gov/ncipc/wisqars/", "accessDate": "2009-02-14T20:11:28Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [ { "tag": "CDC" }, { "tag": "Fall-Related Injury" }, { "tag": "FallSaver" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "FA4WZSQD", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/FA4WZSQD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/FA4WZSQD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Ganz et al.", "parsedDate": "2007-01-03", "numChildren": 0 }, "data": { "key": "FA4WZSQD", "version": 1, "itemType": "journalArticle", "title": "Will my patient fall?", "creators": [ { "creatorType": "author", "firstName": "David A", "lastName": "Ganz" }, { "creatorType": "author", "firstName": "Yeran", "lastName": "Bao" }, { "creatorType": "author", "firstName": "Paul G", "lastName": "Shekelle" }, { "creatorType": "author", "firstName": "Laurence Z", "lastName": "Rubenstein" } ], "abstractNote": "CONTEXT: Effective multifactorial interventions reduce the frequent falling rate of older patients by 30% to 40%. However, clinical consensus suggests reserving these interventions for high-risk patients. Limiting fall prevention programs to high-risk patients implies that clinicians must recognize features that predict future falls. OBJECTIVE: To identify the prognostic value of risk factors for future falls among older patients. DATA SOURCES AND STUDY SELECTION: Search of MEDLINE (1966-September 2004), CINAHL (1982-September 2004), and authors' own files to identify prospective cohort studies of risk factors for falls that performed a multivariate analysis of such factors. DATA EXTRACTION: Two reviewers independently determined inclusion of articles and assessed study quality. Disagreements were resolved by consensus. Included studies were those identifying the prognostic value of risk factors for future falls among community-dwelling persons 65 years and older. Clinically identifiable risk factors were identified across 6 domains: orthostatic hypotension, visual impairment, impairment of gait or balance, medication use, limitations in basic or instrumental activities of daily living, and cognitive impairment. DATA SYNTHESIS: Eighteen studies met inclusion criteria and provided a multivariate analysis including at least 1 of the risk factor domains. The estimated pretest probability of falling at least once in any given year for individuals 65 years and older was 27% (95% confidence interval, 19%-36%). Patients who have fallen in the past year are more likely to fall again [likelihood ratio range, 2.3-2.8]. The most consistent predictors of future falls are clinically detected abnormalities of gait or balance (likelihood ratio range, 1.7-2.4). Visual impairment, medication variables, decreased activities of daily living, and impaired cognition did not consistently predict falls across studies. Orthostatic hypotension did not predict falls after controlling for other factors. CONCLUSIONS: Screening for risk of falling during the clinical examination begins with determining if the patient has fallen in the past year. For patients who have not previously fallen, screening consists of an assessment of gait and balance. Patients who have fallen or who have a gait or balance problem are at higher risk of future falls.", "publicationTitle": "JAMA: The Journal of the American Medical Association", "publisher": "", "place": "", "date": "Jan 3, 2007", "volume": "297", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "77-86", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "JAMA", "DOI": "10.1001/jama.297.1.77", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/17200478", "accessDate": "2009-02-14T19:05:15Z", "PMID": "", "PMCID": "", "ISSN": "1538-3598", "archive": "", "archiveLocation": "1252", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17200478", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Balance and Gait" }, { "tag": "Cost Paper" }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Hardcopy" }, { "tag": "Key" }, { "tag": "Physical Examination", "type": 1 }, { "tag": "Postural Balance", "type": 1 }, { "tag": "Risk Factors" }, { "tag": "VA" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "SUMM2BMJ", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/SUMM2BMJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/SUMM2BMJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Villar et al.", "parsedDate": "1998-03", "numChildren": 0 }, "data": { "key": "SUMM2BMJ", "version": 1, "itemType": "journalArticle", "title": "Will elderly rest home residents wear hip protectors?", "creators": [ { "creatorType": "author", "firstName": "M T", "lastName": "Villar" }, { "creatorType": "author", "firstName": "P", "lastName": "Hill" }, { "creatorType": "author", "firstName": "H", "lastName": "Inskip" }, { "creatorType": "author", "firstName": "P", "lastName": "Thompson" }, { "creatorType": "author", "firstName": "C", "lastName": "Cooper" } ], "abstractNote": "BACKGROUND: Hip fracture is a common cause of morbidity and mortality in elderly people, for whom osteoporosis, the risk of falling and direct trauma to the hip during the fall are the major risk factors. External hip protectors have been developed which reduce the risk of hip fracture after a fall. However, compliance with their use is uncertain. We addressed this issue in a sample of elderly Dorset rest home residents over a 3-month period. METHODS: 31 rest homes agreed to participate. Of the 288 female subjects approached, 141 gave their informed consent and 101 were allocated to the intervention arm of the study. Their ages ranged from 64 to 98 years, and 44% reported a fall during the preceding 12 months. Each subject was fitted with three pairs of protector pads (Sahvatex, Denmark) sewn into specially designed undergarments. Randomly timed fortnightly visits were made to each subject to assess compliance for 12 weeks. FINDINGS: 27 subjects were compliant for the whole study period; 54 wore the protector pads for less than a week, largely for reasons of poor fitting or discomfort; the remainder withdrew at varying intervals between 1 and 12 weeks. During the study period, there were nine recorded falls onto the hip, six of which occurred in women wearing protectors. None resulted in hip fracture. CONCLUSION: Approximately 50% of elderly rest home residents who are mentally able would wear hip protectors in order to prevent hip fractures. Long-term compliance drops to about 30%. Compliance could be increased substantially if the pads and undergarments were modified to enhance their fit and to reduce the discomfort associated with their use.", "publicationTitle": "Age and Ageing", "publisher": "", "place": "", "date": "Mar 1998", "volume": "27", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "195-8", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Age Ageing", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16296679", "accessDate": "2009-03-04T20:40:15Z", "PMID": "", "PMCID": "", "ISSN": "0002-0729", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16296679", "tags": [ { "tag": "Compliance" }, { "tag": "FallSaver" }, { "tag": "Hip protectors" }, { "tag": "Homes for the Aged" }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Patient Satisfaction", "type": 1 }, { "tag": "Protective Clothing", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "U45E3PS6", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/U45E3PS6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/U45E3PS6", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Dykes et al.", "parsedDate": "2009-06", "numChildren": 0 }, "data": { "key": "U45E3PS6", "version": 1, "itemType": "journalArticle", "title": "Why do patients in acute care hospitals fall? Can falls be prevented?", "creators": [ { "creatorType": "author", "firstName": "Patricia C", "lastName": "Dykes" }, { "creatorType": "author", "firstName": "Diane L", "lastName": "Carroll" }, { "creatorType": "author", "firstName": "Ann C", "lastName": "Hurley" }, { "creatorType": "author", "firstName": "Angela", "lastName": "Benoit" }, { "creatorType": "author", "firstName": "Blackford", "lastName": "Middleton" } ], "abstractNote": "OBJECTIVE: Obtain the views of nurses and assistants as to why patients in acute care hospitals fall. BACKGROUND: Despite a large quantitative evidence base for guiding fall risk assessment and not needing highly technical, scarce, or expensive equipment to prevent falls, falls are serious problems in hospitals. METHODS: Basic content analysis methods were used to interpret descriptive data from 4 focus groups with nurses (n = 23) and 4 with assistants (n = 19). A 2-person consensus approach was used for analysis. RESULTS: Positive and negative components of 6 concepts-patient report, information access, signage, environment, teamwork, and involving patient/family-formed 2 core categories: knowledge/ communication and capability/actions that are facilitators or barriers, respectively, to preventing falls. CONCLUSION: Two conditions are required to reduce patient falls. A patient care plan including current and accurate fall risk status with associated tailored and feasible interventions needs to be easily and immediately accessible to all stakeholders (entire healthcare team, patients, and family). Second, stakeholders must use that information plus their own knowledge and skills and patient and hospital resources to carry out the plan.", "publicationTitle": "The Journal of Nursing Administration", "publisher": "", "place": "", "date": "Jun 2009", "volume": "39", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "299-304", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Nurs Adm", "DOI": "10.1097/NNA.0b013e3181a7788a", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19509605", "accessDate": "2009-07-17T02:36:37Z", "PMID": "", "PMCID": "", "ISSN": "1539-0721", "archive": "", "archiveLocation": "", "shortTitle": "Why do patients in acute care hospitals fall?", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19509605", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Acute Disease", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Attitude of Health Personnel", "type": 1 }, { "tag": "Audiovisual Aids", "type": 1 }, { "tag": "Causality", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Female", "type": 1 }, { "tag": "Focus Groups", "type": 1 }, { "tag": "Health Facility Environment", "type": 1 }, { "tag": "Health Services Needs and Demand", "type": 1 }, { "tag": "Hospital" }, { "tag": "Inpatients", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Nurses' Aides", "type": 1 }, { "tag": "Nursing Assessment", "type": 1 }, { "tag": "Nursing Methodology Research", "type": 1 }, { "tag": "Nursing Staff, Hospital", "type": 1 }, { "tag": "Patient Care Planning", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Safety Management", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "QZX9CQTV", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/QZX9CQTV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/QZX9CQTV", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "van der Helm et al.", "parsedDate": "2006-03", "numChildren": 0 }, "data": { "key": "QZX9CQTV", "version": 1, "itemType": "journalArticle", "title": "When implementation fails: the case of a nursing guideline for fall prevention", "creators": [ { "creatorType": "author", "firstName": "Jelle", "lastName": "van der Helm" }, { "creatorType": "author", "firstName": "Astrid", "lastName": "Goossens" }, { "creatorType": "author", "firstName": "Patrick", "lastName": "Bossuyt" } ], "abstractNote": "BACKGROUND: Implementing guidelines can be very difficult. No magic bullet or step-by-step implementation plan is available, neither is any single implementation strategy superior. At the Academic Medical Center (AMC) in Amsterdam, a nursing guideline was developed in 1993 on prevention of patient falls. Falls decreased by 30% on six wards, yet an effort to implement the guideline into daily practice throughout the hospital failed. A renewed effort was made to implement the guideline in two wards (neurology and internal medicine) in 1999. IMPLEMENTING THE GUIDELINE: Preparations were made for implementation in the two wards. Barriers to change were identified and solutions were translated into day-to-day activities in the wards. The intervention period covered 18 months (January 2000-June 2001). A mix of implementation strategies was used, including a local consensus process, educational activities, and active support and feedback to management and staff. RESULTS: In the internal medicine ward, the target incidence of 6% was met for four of the 18 months in the intervention period. In the neurology ward, the incidence target of 11% was met in five months. DISCUSSION: Barriers to change and enabling factors may only become apparent during the implementation process itself. A strongly perceived need to change daily practice, a simple guideline, the hospital board's support, an understanding of local barriers, monitoring of outcomes, a locally tailored multifaceted implementation strategy, and voluntarily cooperating nurses are no guarantees for success.", "publicationTitle": "Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources", "publisher": "", "place": "", "date": "Mar 2006", "volume": "32", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "152-60", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Jt Comm J Qual Patient Saf", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16617946", "accessDate": "2009-03-01T16:01:17Z", "PMID": "", "PMCID": "", "ISSN": "1553-7250", "archive": "", "archiveLocation": "", "shortTitle": "When implementation fails", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16617946", "tags": [ { "tag": "Attitude of Health Personnel" }, { "tag": "Cost Paper" }, { "tag": "Cost-effective" }, { "tag": "Costs and Cost Analysis" }, { "tag": "Fall prevention program" }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Guidelines" }, { "tag": "Key" }, { "tag": "Nursing Care", "type": 1 }, { "tag": "Outcome Assessment (Health Care)" }, { "tag": "Safety Management", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "EKU92IXA", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/EKU92IXA", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/EKU92IXA", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Close et al.", "parsedDate": "2005-12", "numChildren": 0 }, "data": { "key": "EKU92IXA", "version": 1, "itemType": "journalArticle", "title": "What is the role of falls?", "creators": [ { "creatorType": "author", "firstName": "Jacqueline C T", "lastName": "Close" }, { "creatorType": "author", "firstName": "Stephen Lord", "lastName": "Lord" }, { "creatorType": "author", "firstName": "Hylton B", "lastName": "Menz" }, { "creatorType": "author", "firstName": "Catherine", "lastName": "Sherrington" } ], "abstractNote": "There is now firm evidence to support interventions in the prevention of falls in older people, and emerging data support prevention of falls as a method of fracture prevention. This chapter discusses the epidemiology of falls, risk factors associated with an increased risk of falling, assessment of the older faller, and evidence-based approaches to the prevention of falls in the older person. Several randomized controlled trials have found that hip protectors, if worn, probably prevent hip fractures, but that poor compliance is a major issue limiting the effectiveness of this form of intervention. More data are needed to support the role of prevention of falls in preventing fractures, as well as comparative cost-effectiveness data with other evidence-based approaches to preventing fractures in an older population.", "publicationTitle": "Best Practice & Research. Clinical Rheumatology", "publisher": "", "place": "", "date": "Dec 2005", "volume": "19", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "913-35", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Best Pract Res Clin Rheumatol", "DOI": "10.1016/j.berh.2005.06.002", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16301187", "accessDate": "2009-03-05T08:33:55Z", "PMID": "", "PMCID": "", "ISSN": "1521-6942", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16301187", "tags": [ { "tag": "Causality - Positive" }, { "tag": "Compliance" }, { "tag": "Cost-effective" }, { "tag": "FallSaver" }, { "tag": "Geriatric Assessment", "type": 1 }, { "tag": "Hip protectors" }, { "tag": "Intervention Studies" }, { "tag": "Postural Balance", "type": 1 }, { "tag": "Protective Devices", "type": 1 }, { "tag": "Randomized Controlled Trials as Topic", "type": 1 }, { "tag": "Risk Factors" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "V3QIQM7T", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/V3QIQM7T", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/V3QIQM7T", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Tideiksaar and Kay", "parsedDate": "1986-12", "numChildren": 0 }, "data": { "key": "V3QIQM7T", "version": 1, "itemType": "journalArticle", "title": "What causes falls? A logical diagnostic procedure", "creators": [ { "creatorType": "author", "firstName": "R", "lastName": "Tideiksaar" }, { "creatorType": "author", "firstName": "A D", "lastName": "Kay" } ], "abstractNote": "Any fall in the elderly may signal impending major illness. Falls may be caused by any acute or chronic illness that causes weakness or dizziness. MI, stroke, or GI bleeding may well present with falls. A fall can be the first sign of urinary tract, respiratory, or gallbladder infection. Avoid open-ended questions, such as \"What happened?\" Patients often state they slipped or tripped--possibly not the true reason for the fall. Direct questions about symptoms (\"Did you have difficulty in walking?\" or \"Did you feel dizzy?\") elicit more specific information.", "publicationTitle": "Geriatrics", "publisher": "", "place": "", "date": "Dec 1986", "volume": "41", "issue": "12", "section": "", "partNumber": "", "partTitle": "", "pages": "32-50", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Geriatrics", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/3781252", "accessDate": "2009-07-17T01:21:13Z", "PMID": "", "PMCID": "", "ISSN": "0016-867X", "archive": "", "archiveLocation": "", "shortTitle": "What causes falls?", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 3781252", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Accidents", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Arrhythmias, Cardiac", "type": 1 }, { "tag": "Arterial Occlusive Diseases", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Gait", "type": 1 }, { "tag": "Hearing Disorders", "type": 1 }, { "tag": "Hypotension, Orthostatic", "type": 1 }, { "tag": "Nervous System Diseases", "type": 1 }, { "tag": "Pharmaceutical Preparations", "type": 1 }, { "tag": "Seizures", "type": 1 }, { "tag": "Sensation", "type": 1 }, { "tag": "Syncope", "type": 1 }, { "tag": "Vision Disorders", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "23QARFFD", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/23QARFFD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/23QARFFD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "CALNOC", "numChildren": 0 }, "data": { "key": "23QARFFD", "version": 1, "itemType": "webpage", "title": "Welcome to CalNOC site", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "CALNOC" } ], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "https://www.calnoc.org/globalPages/mainpage.aspx", "accessDate": "2009-03-23T01:55:38Z", "shortTitle": "", "language": "", "rights": "", "extra": "1998-1999 data at 1614", "tags": [ { "tag": "Causality - Negative" }, { "tag": "FallSaver" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "BVTN93QF", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/BVTN93QF", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/BVTN93QF", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Porter", "parsedDate": "2005-10", "numChildren": 0 }, "data": { "key": "BVTN93QF", "version": 1, "itemType": "journalArticle", "title": "Wearing and using personal emergency respone system buttons", "creators": [ { "creatorType": "author", "firstName": "Eileen J", "lastName": "Porter" } ], "abstractNote": "Frail older adults living alone are at risk for falling and not being found. A personal emergency response system (PERS) is a technological adjunct to home care for such individuals, but little is known of their experiences with the PERS. The experiences of seven frail women (ages 83 to 96) who lived alone were studied using a descriptive phenomenological method. The key phenomenon was temporizing about the PERS button, and the two component phenomena were deciding when to wear it and deciding whether to use it. Findings were contrasted to the existing literature about wearing and using the PERS, which has been focused on compliance. The variations in the experiences of the women in this small sample warrant further research and individualized interventions to enhance consistent use of the PERS by frail older adults.", "publicationTitle": "Journal of Gerontological Nursing", "publisher": "", "place": "", "date": "Oct 2005", "volume": "31", "issue": "10", "section": "", "partNumber": "", "partTitle": "", "pages": "26-33", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Gerontol Nurs", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16262088", "accessDate": "2009-03-01T01:18:17Z", "PMID": "", "PMCID": "", "ISSN": "0098-9134", "archive": "", "archiveLocation": "1746", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16262088", "tags": [ { "tag": "Compliance" }, { "tag": "FallSaver" }, { "tag": "Frail Elderly", "type": 1 }, { "tag": "Hardcopy" }, { "tag": "Intention", "type": 1 }, { "tag": "Longitudinal Studies", "type": 1 }, { "tag": "PERS" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "C2JV2U5P", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/C2JV2U5P", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/C2JV2U5P", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Milch et al.", "parsedDate": "2006-02", "numChildren": 0 }, "data": { "key": "C2JV2U5P", "version": 1, "itemType": "journalArticle", "title": "Voluntary electronic reporting of medical errors and adverse events. An analysis of 92,547 reports from 26 acute care hospitals", "creators": [ { "creatorType": "author", "firstName": "Catherine E", "lastName": "Milch" }, { "creatorType": "author", "firstName": "Deeb N", "lastName": "Salem" }, { "creatorType": "author", "firstName": "Stephen G", "lastName": "Pauker" }, { "creatorType": "author", "firstName": "Thomas G", "lastName": "Lundquist" }, { "creatorType": "author", "firstName": "Sanjaya", "lastName": "Kumar" }, { "creatorType": "author", "firstName": "Jack", "lastName": "Chen" } ], "abstractNote": "OBJECTIVE: To describe the rate and types of events reported in acute care hospitals using an electronic error reporting system (e-ERS). DESIGN: Descriptive study of reported events using the same e-ERS between January 1, 2001 and September 30, 2003. SETTING: Twenty-six acute care nonfederal hospitals throughout the U.S. that voluntarily implemented a web-based e-ERS for at least 3 months. PARTICIPANTS: Hospital employees and staff. INTERVENTION: A secure, standardized, commercially available web-based reporting system. RESULTS: Median duration of e-ERS use was 21 months (range 3 to 33 months). A total of 92,547 reports were obtained during 2,547,154 patient-days. Reporting rates varied widely across hospitals (9 to 95 reports per 1,000 inpatient-days; median=35). Registered nurses provided nearly half of the reports; physicians contributed less than 2%. Thirty-four percent of reports were classified as nonmedication-related clinical events, 33% as medication/infusion related, 13% were falls, 13% as administrative, and 6% other. Among 80% of reports that identified level of impact, 53% were events that reached a patient (\"patient events\"), 13% were near misses that did not reach the patient, and 14% were hospital environment problems. Among 49,341 patient events, 67% caused no harm, 32% temporary harm, 0.8% life threatening or permanent harm, and 0.4% contributed to patient deaths. CONCLUSIONS: An e-ERS provides an accessible venue for reporting medical errors, adverse events, and near misses. The wide variation in reporting rates among hospitals, and very low reporting rates by physicians, requires investigation.", "publicationTitle": "Journal of General Internal Medicine", "publisher": "", "place": "", "date": "Feb 2006", "volume": "21", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "165-70", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Gen Intern Med", "DOI": "10.1111/j.1525-1497.2006.00322.x", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16390502", "accessDate": "2009-03-14T19:25:59Z", "PMID": "", "PMCID": "", "ISSN": "1525-1497", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16390502", "tags": [ { "tag": "Adverse Drug Reaction Reporting Systems", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Hospital" }, { "tag": "Medical Errors", "type": 1 }, { "tag": "Physicians", "type": 1 }, { "tag": "Risk Management", "type": 1 }, { "tag": "Safety Management", "type": 1 }, { "tag": "Voluntary Programs", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "56TAME9Q", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/56TAME9Q", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/56TAME9Q", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Hendrich et al.", "parsedDate": "2003-02", "numChildren": 0 }, "data": { "key": "56TAME9Q", "version": 1, "itemType": "journalArticle", "title": "Validation of the Hendrich II Fall Risk Model: a large concurrent case/control study of hospitalized patients", "creators": [ { "creatorType": "author", "firstName": "Ann L", "lastName": "Hendrich" }, { "creatorType": "author", "firstName": "Patricia S", "lastName": "Bender" }, { "creatorType": "author", "firstName": "Allen", "lastName": "Nyhuis" } ], "abstractNote": "This large case/control study of fall and non-fall patients, in an acute care tertiary facility, was designed to concurrently test the Hendrich Fall Risk Model. Cases and controls (355/780) were randomly enrolled and assessed for more than 600 risk factors (intrinsic/extrinsic). Standardized instruments were used for key physical attributes as well as clinician assessments. A risk factor model was developed through stepwise logistic regression. Two-way interactions among the risk factors were tested for significance. The best fitting model included 2 Log L chi square statistic as well as sensitivity and specificity values retrospectively. The result of the study is an easy to use validated Hendrich Fall Risk Model with eight assessment parameters for high-risk fall identification tested in acute care environments.", "publicationTitle": "Applied Nursing Research: ANR", "publisher": "", "place": "", "date": "Feb 2003", "volume": "16", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "9-21", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Appl Nurs Res", "DOI": "10.1053/apnr.2003.YAPNR2", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/12624858", "accessDate": "2009-03-01T02:59:54Z", "PMID": "", "PMCID": "", "ISSN": "0897-1897", "archive": "", "archiveLocation": "1245", "shortTitle": "Validation of the Hendrich II Fall Risk Model", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12624858", "tags": [ { "tag": "Case-Control Studies", "type": 1 }, { "tag": "Concurrent Review", "type": 1 }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Hardcopy" }, { "tag": "Hospitals", "type": 1 }, { "tag": "Logistic Models", "type": 1 }, { "tag": "Models, Theoretical", "type": 1 }, { "tag": "Nursing Assessment", "type": 1 }, { "tag": "Reproducibility of Results", "type": 1 }, { "tag": "Risk Factors" }, { "tag": "Sensitivity and Specificity", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "KENJ5RRN", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/KENJ5RRN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/KENJ5RRN", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Donaldson et al.", "parsedDate": "2007-04", "numChildren": 0 }, "data": { "key": "KENJ5RRN", "version": 1, "itemType": "journalArticle", "title": "Utility of the mean cumulative function in the analysis of fall events", "creators": [ { "creatorType": "author", "firstName": "Meghan G", "lastName": "Donaldson" }, { "creatorType": "author", "firstName": "Boris", "lastName": "Sobolev" }, { "creatorType": "author", "firstName": "Lisa", "lastName": "Kuramoto" }, { "creatorType": "author", "firstName": "Wendy L", "lastName": "Cook" }, { "creatorType": "author", "firstName": "Karim M", "lastName": "Khan" }, { "creatorType": "author", "firstName": "Patti A", "lastName": "Janssen" } ], "abstractNote": "BACKGROUND: Falls are the most common cause of injury among elderly people; half of those people fall recurrently. The objective of these simulation studies was to describe the Mean Cumulative Function (MCF) and to evaluate the utility of the MCF in detecting differences between groups experiencing different patterns of event intensities. METHODS: We specified 250 participants per group with a maximum follow-up time of 365 days. A participant could experience 0, 1, 2, 3, or 4 falls. In the baseline experiment, Groups A and B had an average intensity of 60 and 90 days to the first fall event. These event intensities remained constant for events 2-4. Group C represents a short term \"strong\" initial impact of the intervention modeled for falls 1 and 2, with an average intensity of one fall per 117 days; however, the intervention wanes to \"moderate\" for falls 3 and 4 with an average intensity of one fall per 90 days. Group D represents a long-term \"strong\" impact of the intervention modeled by an average intensity of one fall per 117 days for all subsequent events. RESULTS: The MCF was able to detect differences between groups that had varying intensities of subsequent falls. In Group A, all participants experienced at least one fall, whereas Groups B, C, and D had 4, 9, and 15 participants, respectively, who did not experience any falls. The proportion of participants who had 4 falls declined from 84% to 40% in Groups A and D, respectively. When Group A was compared to Group D, the MCF difference detected the prevention of, on average, one fall per person within 175 days. Discussion. A novel instrument for this field of clinical research--the MCF--allows investigators to compare the average number of falls per participant when the intervention reduces the intensity of subsequent falls.", "publicationTitle": "The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences", "publisher": "", "place": "", "date": "Apr 2007", "volume": "62", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "415-9", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Gerontol A Biol Sci Med Sci", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/17452736", "accessDate": "2009-03-01T00:30:32Z", "PMID": "", "PMCID": "", "ISSN": "1079-5006", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 17452736", "tags": [ { "tag": "Computer Simulation", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Humans", "type": 1 }, { "tag": "Intervention Studies" }, { "tag": "Models, Theoretical", "type": 1 }, { "tag": "Recurrence", "type": 1 }, { "tag": "Statistics" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "563T46X8", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/563T46X8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/563T46X8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Gowdy and Godfrey", "parsedDate": "2003-07", "numChildren": 0 }, "data": { "key": "563T46X8", "version": 1, "itemType": "journalArticle", "title": "Using tools to assess and prevent inpatient falls", "creators": [ { "creatorType": "author", "firstName": "Marie", "lastName": "Gowdy" }, { "creatorType": "author", "firstName": "Shawn", "lastName": "Godfrey" } ], "abstractNote": "BACKGROUND: Inpatient falls and fall-related injuries continue to be a complex challenge that health care organizations face. Protecting patients from falls and injury and ensuring a safe environment are fundamental to providing high-quality care. FACING THE PROBLEM: In June 2000 NorthEast Medical Center (Concord, North Carolina) experienced an inpatient fall rate (6.1 falls/1,000 patient days) that exceeded the internal benchmark (4.1 falls/1,000 patient days). The interdisciplinary Fall Team developed the Fall Risk Assessment tool. Patients were given a fall risk score and were categorized as either low or high risk. Interventions were chosen by the caregiver and became part of each patient's overall safety plan of care. THE NEXT STEP: Root cause analyses were performed for each inpatient fall to expose possible relationships between assessed fall risks and root causes. For example, approximately 80% of the patients who fell were confused, had gait disturbance, and were attempting to toilet alone. Through use of Failure Mode and Effects Analysis, the team was able to review the fall process in a prospective fashion. FOCUS ON HIGH-RISK INPATIENT POPULATIONS: In January 2001 the Fall Team began to focus on preventing falls in this patient population. An action plan for fall prevention was implemented, resulting in a decrease from 67 to 28 falls per 1,000 patient days. RESULTS: From the team's inception in June 2000 to the first quarter of 2003, the inpatient fall rate decreased from 6.1 to 2.6 falls per 1,000 patient days--a 43% decrease. With increased patient acuity and specialization in care of new and more challenging patient populations, health care organizations must quickly identify patients' fall risks and develop innovative methods to prevent falls.", "publicationTitle": "Joint Commission Journal on Quality and Safety", "publisher": "", "place": "", "date": "Jul 2003", "volume": "29", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "363-8", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Jt Comm J Qual Saf", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/12856558", "accessDate": "2009-02-14T18:16:16Z", "PMID": "", "PMCID": "", "ISSN": "1549-3741", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 12856558", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Benchmarking", "type": 1 }, { "tag": "Fall prevention program" }, { "tag": "FallSaver" }, { "tag": "Geriatric Assessment", "type": 1 }, { "tag": "Hospital Bed Capacity, 300 to 499", "type": 1 }, { "tag": "Hospitals, Community", "type": 1 }, { "tag": "Hospitals, Voluntary", "type": 1 }, { "tag": "Institutional Management Teams", "type": 1 }, { "tag": "North Carolina", "type": 1 }, { "tag": "Psychiatric Department, Hospital", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Safety Management", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "763QTPNM", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/763QTPNM", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/763QTPNM", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Nyberg and Gustafson", "parsedDate": "1996-10", "numChildren": 0 }, "data": { "key": "763QTPNM", "version": 1, "itemType": "journalArticle", "title": "Using the Downton index to predict those prone to falls in stroke rehabilitation", "creators": [ { "creatorType": "author", "firstName": "L", "lastName": "Nyberg" }, { "creatorType": "author", "firstName": "Y", "lastName": "Gustafson" } ], "abstractNote": "BACKGROUND AND PURPOSE: Falls are a major complication in inpatient stroke rehabilitation. An important issue in preventive strategies is the early identification of those at risk. This study aimed at assessing the fall-prediction accuracy of an easily administered fall risk index in stroke rehabilitation. METHODS: A consecutive series of 135 patients admitted to a geriatric stroke rehabilitation unit was studied. A score on the Downton fall risk index was obtained from the admission assessment data and used as a predictive indicator of the risk of falls. The patients' falls were prospectively recorded during their rehabilitation stay. The correlation between falls and the predicted risk was assessed by means of survival analysis and a multiple regression analysis, adjusting for the time of observation. RESULTS: The risk of falls as a function of the time observed was significantly greater among those predicted to be at high risk (index score > or = 3) than among the others (P = .009, log-rank test; odds ratio, 2.9). Furthermore, the number of falls during rehabilitation stay was moderately correlated (R = .57) with the fall risk index sum when adjusted as for the time of observation. The sensitivity of the fall prediction as to outcome was 91%, whereas the specificity was limited to 27%. CONCLUSIONS: A moderately high correlation was found between the predicted and the observed risk of falls in stroke rehabilitation when the Downton fall risk index was used. However, a low specificity rate limits the accuracy of the prediction.", "publicationTitle": "Stroke; a Journal of Cerebral Circulation", "publisher": "", "place": "", "date": "Oct 1996", "volume": "27", "issue": "10", "section": "", "partNumber": "", "partTitle": "", "pages": "1821-4", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Stroke", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/8841338", "accessDate": "2009-03-22T17:57:34Z", "PMID": "", "PMCID": "", "ISSN": "0039-2499", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 8841338", "tags": [ { "tag": "Accident Proneness", "type": 1 }, { "tag": "Causality - Negative" }, { "tag": "Cerebrovascular Disorders", "type": 1 }, { "tag": "Evaluation Studies as Topic", "type": 1 }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Female", "type": 1 }, { "tag": "Forecasting", "type": 1 }, { "tag": "Inpatients", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Preventive Medicine", "type": 1 }, { "tag": "Rehabilitation" }, { "tag": "Sensitivity and Specificity", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "Z5VDE639", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/Z5VDE639", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/Z5VDE639", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Guyatt", "parsedDate": "2000-09-13", "numChildren": 0 }, "data": { "key": "Z5VDE639", "version": 1, "itemType": "journalArticle", "title": "Users' Guides to the Medical Literature: XXV. Evidence-based medicine: principles for applying the Users' Guides to patient care. Evidence-Based Medicine Working Group.", "creators": [ { "creatorType": "author", "firstName": "GH", "lastName": "Guyatt" } ], "abstractNote": "This series provides clinicians with strategies and tools to interpret and integrate evidence from published research in their care of patients. The 2 key principles for applying all the articles in this series to patient care relate to the value-laden nature of clinical decisions and to the hierarchy of evidence postulated by evidence-based medicine. Clinicians need to be able to distinguish high from low quality in primary studies, systematic reviews, practice guidelines, and other integrative research focused on management recommendations. An evidence-based practitioner must also understand the patient's circumstances or predicament; identify knowledge gaps and frame questions to fill those gaps; conduct an efficient literature search; critically appraise the research evidence; and apply that evidence to patient care. However, treatment judgments often reflect clinician or societal values concerning whether intervention benefits are worth the cost. Many unanswered questions concerning how to elicit preferences and how to incorporate them in clinical encounters constitute an enormously challenging frontier for evidence-based medicine. Time limitation remains the biggest obstacle to evidence-based practice but clinicians should seek evidence from as high in the appropriate hierarchy of evidence as possible, and every clinical decision should be geared toward the particular circumstances of the patient.", "publicationTitle": "JAMA", "publisher": "", "place": "", "date": "2000 Sep 13", "volume": "284", "issue": "10", "section": "", "partNumber": "", "partTitle": "", "pages": "1290-6", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10979117&log$=activity", "accessDate": "2009-02-23T03:29:04Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "1269", "shortTitle": "", "language": "", "libraryCatalog": "", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Evidence-Based" }, { "tag": "FallSaver" }, { "tag": "Hardcopy" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "RDFTWMI7", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/RDFTWMI7", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/RDFTWMI7", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Boissy et al.", "parsedDate": "2007-12-01", "numChildren": 0 }, "data": { "key": "RDFTWMI7", "version": 1, "itemType": "journalArticle", "title": "User-Based Motion Sensing and Fuzzy Logic for Automated Fall Detection in Older Adults", "creators": [ { "creatorType": "author", "firstName": "Patrick", "lastName": "Boissy" }, { "creatorType": "author", "firstName": "Stéphane", "lastName": "Choquette" }, { "creatorType": "author", "firstName": "Mathieu", "lastName": "Hamel" }, { "creatorType": "author", "firstName": "Norbert", "lastName": "Noury" } ], "abstractNote": "Fall detection and early medical response are challenging and promising aspects of home healthcare for older adults. A two-step algorithm for falls analyzed accelerometer data for 750 test events and found significance limits for body trunk angle change as well as falls. Automated detection of falls based upon motion sensing and fuzzy logic can be based upon evidence-derived rules.\n\nMore than one third of community-dwelling older adults and up to 60% of nursing home residents fall each year, with 10–15% of fallers sustaining a serious injury. Reliable automated fall detection can increase confidence in people with fear of falling, promote active safe living for older adults, and reduce complications from falls. The performance of a 2-stage fall detection algorithm using impact magnitudes and changes in trunk angles derived from user-based motion sensors was evaluated under laboratory conditions. Ten healthy participants were instrumented on the front and side of the trunk with 3D accelerometers. Participants simulated 9 fall conditions and 6 common activities of daily living. Fall conditions were simulated on a protective mattress. The experimental data set comprised 750 events (45 fall events and 30 nonfall events per participant) that were classified by the fall detection algorithm as either a fall or a nonfall using inputs from 3D accelerometers. Significant differences for impacts recorded, trunk angle changes (p < 0.01), and detection performances (p < 0.05) were found between fall and nonfall conditions. The proposed algorithm detected fall events during simulated fall conditions with a success rate of 93% and a false-positive rate of 29% during nonfall conditions. Despite a slightly superior identification performance for the accelerometer located on the front of the trunk, no significant differences were found between the two motion sensor locations. Automated detection of fall events based on user-based motion sensing and fuzzy logic shows promising results. Additional rules and optimization of the algorithm will be needed to decrease the false-positive rate.", "publicationTitle": "Telemedicine and e-Health", "publisher": "", "place": "", "date": "2007 Dec 1", "volume": "13", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "683-94", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "http://www.liebertonline.com/doi/abs/10.1089/tmj.2007.0007", "accessDate": "2009-03-01T01:29:43Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "", "callNumber": "", "rights": "Mary Ann Liebert, Inc.", "extra": "Fall detection and early medical response are challenging and promising aspects of home healthcare for older adults. A two-step algorithm for falls analyzed accelerometer data for 750 test events and found significance limits for body trunk angle change as well as falls. Automated detection of falls based upon motion sensing and fuzzy logic can be based upon evidence-derived rules.", "tags": [ { "tag": "Fall detection" }, { "tag": "FallSaver" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "ETXV2PJG", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/ETXV2PJG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/ETXV2PJG", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Findorff et al.", "parsedDate": "2005-08", "numChildren": 0 }, "data": { "key": "ETXV2PJG", "version": 1, "itemType": "journalArticle", "title": "Use of time studies for determining intervention costs", "creators": [ { "creatorType": "author", "firstName": "Mary J", "lastName": "Findorff" }, { "creatorType": "author", "firstName": "Jean F", "lastName": "Wyman" }, { "creatorType": "author", "firstName": "Catherine F", "lastName": "Croghan" }, { "creatorType": "author", "firstName": "John A", "lastName": "Nyman" } ], "abstractNote": "BACKGROUND: Cost-effectiveness analyses are increasingly recommended to evaluate the effectiveness of health interventions. Determining the costs associated with delivery of a particular intervention is essential in conducting a cost-effectiveness analysis. Yet, there are few guidelines available to assist investigators in how to assess intervention costs associated with the personnel portion of an intervention. OBJECTIVES: To describe the use of time studies in calculating the program costs of personnel for use in future cost-effectiveness analysis of health interventions. METHODS: The literature on calculating intervention costs for use in cost-effectiveness analyses is reviewed. The process for conducting a time study for determining personnel costs in delivering an intervention and a step-by-step example from a time study are used to illustrate how personnel costs associated with delivery of the intervention can be separated from those costs associated with implementation of research procedures in the determination of research costs. CONCLUSIONS: Time studies provide a good estimate of part of the cost of implementing an intervention that is often difficult to determine-personnel time. The design of the time study should consider intervention components, staff involvement, and the time period for data collection.", "publicationTitle": "Nursing Research", "publisher": "", "place": "", "date": "2005 Jul-Aug", "volume": "54", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "280-4", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Nurs Res", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/16027571", "accessDate": "2009-02-14T17:26:47Z", "PMID": "", "PMCID": "", "ISSN": "0029-6562", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 16027571", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Cost Paper" }, { "tag": "Costs and Cost Analysis" }, { "tag": "Data Collection", "type": 1 }, { "tag": "Documentation", "type": 1 }, { "tag": "FallSaver" }, { "tag": "Guidelines" }, { "tag": "Health Services Research", "type": 1 }, { "tag": "Home Care Services", "type": 1 }, { "tag": "Models, Econometric", "type": 1 }, { "tag": "Nursing" }, { "tag": "Nursing Evaluation Research", "type": 1 }, { "tag": "Nursing Records", "type": 1 }, { "tag": "Program Development", "type": 1 }, { "tag": "Research Design", "type": 1 }, { "tag": "Research Personnel", "type": 1 }, { "tag": "Time and Motion Studies", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "TPFSK9TQ", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/TPFSK9TQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/TPFSK9TQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Muir et al.", "parsedDate": "2008-04", "numChildren": 0 }, "data": { "key": "TPFSK9TQ", "version": 1, "itemType": "journalArticle", "title": "Use of the Berg Balance Scale for predicting multiple falls in community-dwelling elderly people: a prospective study", "creators": [ { "creatorType": "author", "firstName": "Susan W", "lastName": "Muir" }, { "creatorType": "author", "firstName": "Katherine", "lastName": "Berg" }, { "creatorType": "author", "firstName": "Bert", "lastName": "Chesworth" }, { "creatorType": "author", "firstName": "Mark", "lastName": "Speechley" } ], "abstractNote": "BACKGROUND AND PURPOSE: Falls are a significant public health concern for older adults; early identification of people at high risk for falling facilitates the provision of rehabilitation treatment to reduce future fall risk. The objective of this prospective cohort study was to examine the predictive validity of the Berg Balance Scale (BBS) for 3 types of outcomes-any fall (> or =1 fall), multiple falls (> or =2 falls), and injurious falls-by use of sensitivity, specificity, receiver operating characteristic (ROC) curves, area under the curve, and likelihood ratios. SUBJECTS AND METHODS: A sample of 210 community-dwelling older adults received a comprehensive geriatric assessment at baseline, which included the BBS to measure balance. Data on prospective falls were collected monthly for a year. The predictive validity of the BBS for the identification of future fall risk was evaluated. RESULTS: The BBS had good discriminative ability to predict multiple falls when ROC analysis was used. However, the use of the BBS as a dichotomous scale, with a threshold of < or =45, was inadequate for the identification of the majority of people at risk for falling in the future, with sensitivities of 25% and 45% for any fall and for multiple falls, respectively. The use of likelihood ratios, maintaining the BBS as a multilevel scale, demonstrated a gradient of risk across scores, with fall risk increasing as scores decreased. DISCUSSION AND CONCLUSION: The use of the BBS as a dichotomous scale to identify people at high risk for falling should be discouraged because it fails to identify the majority of such people. The predictive validity of this scale for multiple falls is superior to that for other types of falls, and the use of likelihood ratios preserves the gradient of risk across the whole range of scores.", "publicationTitle": "Physical Therapy", "publisher": "", "place": "", "date": "Apr 2008", "volume": "88", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "449-59; discussion 460-1", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Phys Ther", "DOI": "10.2522/ptj.20070251", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/18218822", "accessDate": "2009-02-14T19:16:06Z", "PMID": "", "PMCID": "", "ISSN": "1538-6724", "archive": "", "archiveLocation": "", "shortTitle": "Use of the Berg Balance Scale for predicting multiple falls in community-dwelling elderly people", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18218822", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Canada" }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Geriatric Assessment", "type": 1 }, { "tag": "Health Status Indicators", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Likelihood Functions", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Predictive Value of Tests", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "ROC Curve", "type": 1 }, { "tag": "Risk Assessment", "type": 1 }, { "tag": "Sensitivity and Specificity", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "G3D8E72N", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/G3D8E72N", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/G3D8E72N", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Wagner et al.", "parsedDate": "2008-04", "numChildren": 0 }, "data": { "key": "G3D8E72N", "version": 1, "itemType": "journalArticle", "title": "Use of a falls incident reporting system to improve care process documentation in nursing homes", "creators": [ { "creatorType": "author", "firstName": "L M", "lastName": "Wagner" }, { "creatorType": "author", "firstName": "E", "lastName": "Capezuti" }, { "creatorType": "author", "firstName": "P C", "lastName": "Clark" }, { "creatorType": "author", "firstName": "P A", "lastName": "Parmelee" }, { "creatorType": "author", "firstName": "J G", "lastName": "Ouslander" } ], "abstractNote": "BACKGROUND: Falls are the most frequently reported adverse event among frail nursing home residents and are an important resident safety issue. Incident reporting systems have been successfully used to improve quality and safety in healthcare. The purpose of this study was to test the effect of a systematically guided menu-driven incident reporting system (MDIRS) on documentation of post-fall evaluation processes in nursing homes. METHODS: Six for-profit nursing homes in southeastern USA participated in the study. Over a 4-month period, MDIRS was used in three nursing homes matched with another three nursing homes which continued using their existing narrative incident report to document falls. Trained geriatric nurse practitioner auditors used a data collection audit tool to collect medical record documentation of the processes of care for residents who fell. Multivariate analysis of covariance was used to compare the post-fall nursing care processes documented in the medical records. RESULTS: 207 medical records of resident who fell were examined. Over 75% of the sample triggered at high risk for falls by the minimum data set. An adequate neurological assessment was documented for only 18.4% of residents who had experienced a fall. Although two-thirds of the sample had a diagnosis of incontinence, less than 20% of the records had incontinence-related interventions in the nursing care plan. Overall, there was more complete documentation of the post-fall evaluation process in the medical records in nursing homes using the MDIRS than in nursing homes using standard narrative incident reports (p<0.001). CONCLUSION: Further improvements are necessary in reporting mechanisms to improve the post-fall assessment in nursing home residents.", "publicationTitle": "Quality & Safety in Health Care", "publisher": "", "place": "", "date": "Apr 2008", "volume": "17", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "104-8", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Qual Saf Health Care", "DOI": "10.1136/qshc.2007.022947", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/18385403", "accessDate": "2009-02-14T19:35:32Z", "PMID": "", "PMCID": "", "ISSN": "1475-3901", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18385403", "tags": [ { "tag": "Accidental Falls", "type": 1 }, { "tag": "Cost Paper" }, { "tag": "Documentation", "type": 1 }, { "tag": "Fall risk assessment" }, { "tag": "FallSaver" }, { "tag": "Health Facility Size", "type": 1 }, { "tag": "Health Services Research", "type": 1 }, { "tag": "Homes for the Aged" }, { "tag": "Humans", "type": 1 }, { "tag": "Quality Control", "type": 1 }, { "tag": "Risk Management", "type": 1 }, { "tag": "Safety Management", "type": 1 }, { "tag": "United States" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "7XQ8RT8J", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/7XQ8RT8J", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/7XQ8RT8J", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Hasegawa et al.", "parsedDate": "2009-03-16", "numChildren": 0 }, "data": { "key": "7XQ8RT8J", "version": 1, "itemType": "journalArticle", "title": "Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities", "creators": [ { "creatorType": "author", "firstName": "Jun", "lastName": "Hasegawa" }, { "creatorType": "author", "firstName": "Masafumi", "lastName": "Kuzuya" }, { "creatorType": "author", "firstName": "Akihisa", "lastName": "Iguchi" } ], "abstractNote": "Numerous risk factors of falls, including urinary incontinence and behavioral symptoms have been identified among elderly people in long-term care settings. However, it remains uncertain whether incontinence or behavioral symptoms are associated with recurrent falls and injurious falls. The purpose of this research was to examine the association between various types of falls and urinary incontinence or behavioral symptoms among the residents of long-term care facilities using the Cox proportional hazards models. The participants were 1082 older people (327 men and 755 women) who were admitted to facilities between 1 April 2003 and 31 March 2004. Fall experience, urinary incontinence, and behavioral symptoms were followed for up to 6 months or until death or discharge. The functional status, comorbidity, and prescribed medications were determined at the baseline. Multivariate analysis revealed that urinary incontinence and behavioral symptoms were independent risk factors of falls during the follow-up period. However, urinary incontinence was a risk factor for recurrent falls but not for injurious falls. In contrast, behavioral symptoms were an independent risk factor for injurious but not for recurrent falls. The results suggested that treatment or management of urinary incontinence and behavioral symptoms should be considered to prevent falls in long-term care settings.", "publicationTitle": "Archives of Gerontology and Geriatrics", "publisher": "", "place": "", "date": "Mar 16, 2009", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Arch Gerontol Geriatr", "DOI": "10.1016/j.archger.2009.02.001", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19297035", "accessDate": "2009-04-04T16:52:58Z", "PMID": "", "PMCID": "", "ISSN": "1872-6976", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19297035", "tags": [ { "tag": "Behavioral Symptoms" }, { "tag": "Fall risk assessment" }, { "tag": "Fall-Related Injury" }, { "tag": "FallSaver" }, { "tag": "Risk Factors" }, { "tag": "Urinary Incontinence" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "AH7VKVKN", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/AH7VKVKN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/AH7VKVKN", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Weiss", "numChildren": 0 }, "data": { "key": "AH7VKVKN", "version": 1, "itemType": "webpage", "title": "University of Nevada, Reno - Sanford Center for Aging", "creators": [ { "creatorType": "author", "firstName": "Larry", "lastName": "Weiss" } ], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.unr.edu/sanford/about/", "accessDate": "2009-03-14T18:57:13Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [ { "tag": "Contacts" }, { "tag": "FallSaver" }, { "tag": "Organizations" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "X7QAAURR", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/X7QAAURR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/X7QAAURR", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Runyan et al.", "parsedDate": "2005-01", "numChildren": 0 }, "data": { "key": "X7QAAURR", "version": 1, "itemType": "journalArticle", "title": "Unintentional injuries in the home in the United States Part II: morbidity.", "creators": [ { "creatorType": "author", "firstName": "C. W", "lastName": "Runyan" }, { "creatorType": "author", "firstName": "D.", "lastName": "Perkis" }, { "creatorType": "author", "firstName": "S. W", "lastName": "Marshall" }, { "creatorType": "author", "firstName": "R. M", "lastName": "Johnson" }, { "creatorType": "author", "firstName": "T.", "lastName": "Coyne-Beasley" }, { "creatorType": "author", "firstName": "A. E", "lastName": "Waller" }, { "creatorType": "author", "firstName": "C.", "lastName": "Black" }, { "creatorType": "author", "firstName": "L.", "lastName": "Baccaglini" } ], "abstractNote": "BACKGROUND: Homes are an important setting for nonfatal unintentional injuries. The purpose of this study was to quantify and describe nonfatal, unintentional injuries in the United States, in which the injury took place at home. METHODS: Data derived from the National Health Interview Survey, National Ambulatory Medical Care Survey, and National Hospital Ambulatory Medical Care Surveys for Outpatient and Emergency Departments. The nonfatal unintentional home injury rate and 95% confidence interval were computed for the United States overall (1998-1999), as well as by type of injury, gender, and age group. Weights were applied for each data set as designated by the National Center for Health Statistics. RESULTS: In 1998, there were more than 12 million unintentional home injuries requiring some form of medical attention. Falls were the most common injury among all age groups, followed by cutting/piercing injuries, and injuries associated with being struck by or against an object or person. Injury rates were highest among the oldest and youngest age groups. There was inconsistency across data sets with regard to the presence of location information and definitions of the home environment, inclusion criteria, and the presence of external cause of injury and poisoning codes (E-codes). Depending on the data set, information was missing for 8% and 41% of cases on the location of injury, making it impossible to determine whether the injuries occurred in the home environment. CONCLUSIONS: Falls are a significant problem, particularly among older adults. Additionally, data collection systems need to be improved so that location of injury data are routinely collected using consistent definitions so as to allow comparisons across data sets and over time.", "publicationTitle": "Am J Prev Med", "publisher": "", "place": "", "date": "January 2005", "volume": "28", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "80–87", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "http://dx.doi.org/10.1016/j.amepre.2004.09.017", "citationKey": "", "url": "http://dx.doi.org/10.1016/j.amepre.2004.09.017", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0749-3797", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Fall-Related Injury" }, { "tag": "FallSaver" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "TQ8MFHSC", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/TQ8MFHSC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/TQ8MFHSC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Tideiksaar", "parsedDate": "1984-08", "numChildren": 0 }, "data": { "key": "TQ8MFHSC", "version": 1, "itemType": "journalArticle", "title": "Understanding the basics of diagnosis-related groups", "creators": [ { "creatorType": "author", "firstName": "R", "lastName": "Tideiksaar" } ], "abstractNote": "", "publicationTitle": "Physician Assistant (American Academy of Physician Assistants)", "publisher": "", "place": "", "date": "Aug 1984", "volume": "8", "issue": "8", "section": "", "partNumber": "", "partTitle": "", "pages": "47-8, 52, 116", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Physician Assist", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/10310787", "accessDate": "2009-03-01T02:39:17Z", "PMID": "", "PMCID": "", "ISSN": "8750-7544", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 10310787", "tags": [ { "tag": "DRG" }, { "tag": "FallSaver" }, { "tag": "Hospitals", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } }, { "key": "5GVS9AKP", "version": 1, "library": { "type": "group", "id": 3219, "name": "FallSaver", "links": { "alternate": { "href": "https://www.zotero.org/groups/fallsaver", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/3219/items/5GVS9AKP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/fallsaver/items/5GVS9AKP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 12382, "username": "drkitty", "name": "Kathryn E Kelly, DrPH", "links": { "alternate": { "href": "https://www.zotero.org/drkitty", "type": "text/html" } } }, "creatorSummary": "Carroll Healthcare", "numChildren": 0 }, "data": { "key": "5GVS9AKP", "version": 1, "itemType": "webpage", "title": "Twenty Facts on Falls", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "Carroll Healthcare" } ], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "No date", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://209.85.173.132/search?q=cache:N2wSTJeNelQJ:www.invacare-ccg.com/pages/download.php%3Ff_name%3DFacts%2520on%2520Falls-09-03.pdf%26pth%3Df%26PHPSESSID%3Dcd86db0dc0945c404029c6701241f9db+%22St.+Paul+fire%22+marine+insurance+hospital+falls&cd=19&hl=en&ct=clnk&gl=us", "accessDate": "2009-03-22T07:23:33Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [ { "tag": "FallSaver" }, { "tag": "Hardcopy" }, { "tag": "Insurance Claims" }, { "tag": "Key" } ], "collections": [], "relations": {}, "dateAdded": "2009-07-24T00:20:55Z", "dateModified": "2009-07-24T00:20:55Z" } } ]