scholarly journals What works to prevent falls in older adults dwelling in long term care facilities and hospitals? An umbrella review of meta-analyses of randomised controlled trials

Maturitas ◽  
2015 ◽  
Vol 81 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Brendon Stubbs ◽  
Michael D. Denkinger ◽  
Simone Brefka ◽  
Dhayana Dallmeier
Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.


2020 ◽  
Vol 41 (6) ◽  
pp. 992-999
Author(s):  
Iria Dobarrio-Sanz ◽  
José Manuel Hernández-Padilla ◽  
María Mar López-Rodríguez ◽  
Cayetano Fernández-Sola ◽  
José Granero-Molina ◽  
...  

Author(s):  
Sienna Caspar ◽  
Heather A. Cooke ◽  
Alison Phinney ◽  
Pamela A. Ratner

RÉSUMÉAu cours des trois dernières décennies, il y a eu une augmentation notable dans les études de pratique concernant changements dans les interventions en soins de longue durée (SLD). Cette critique, basé sur une approche réaliste modifiée, répond aux questions suivantes: Quelles caractéristiques de changement d’intervention fonctionnent bien? Et, dans quelles circonstances, fonctionnent-elles, et pourquoi? Une approche réaliste modifiée a été appliquée pour identifier et expliquer les interactions parmi le contexte, le mécanisme, et les résultats. Nous avons cherché des bases de données électroniques et la littérature publiée pour les études empiriques des interventions pratiques modifiées qui (a) ont été menées dans les établissements de SLD, (b) ont impliqué le personnel soignant formel, et (c) ont fait état d’une évaluation formelle. Quatre-vingt-quatre articles répondaient à nos critères d’inclusion. Les interventions qui ne comprenaient que des facteurs prédisposants étaient moins susceptibles d’être efficaces, tandis que les interventions qui comprenaient des facteurs renforçants étaient les plus susceptibles de produire des résultats durables. Nous avons conclu que les interventions visant à changer les pratiques dans les milieux de SLD devraient inclure les facteurs habilitants et renforçants qui sont à la fois réalisables et efficaces.


2002 ◽  
Vol 26 (1) ◽  
pp. 24-26 ◽  
Author(s):  
John Snowdon ◽  
Tom Arie

We are old age psychiatrists; T.A. based in Britain, J.S. in Australia. A return visit by T.A. to Australia allowed us to focus attention on differences between the two countries in their provision of long-term care for old people with mental disabilities. What works well? What constrains development?


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Amanda M. Hall ◽  
Gerd M. Flodgren ◽  
Helen L. Richmond ◽  
Sheila Welsh ◽  
Jacqueline Y. Thompson ◽  
...  

Abstract Background The champion model is increasingly being adopted to improve uptake of guideline-based care in long-term care (LTC). Studies suggest that an on-site champion may improve the quality of care residents’ health outcomes. This review assessed the effectiveness of the champion on staff adherence to guidelines and subsequent resident outcomes in LTC homes. Method This was a systematic review and meta-analyses of randomised controlled trials. Eligible studies included residents aged 65 or over and nursing staff in LTC homes where there was a stand-alone or multi-component intervention that used a champion to improve staff adherence to guidelines and resident outcomes. The measured outcomes included staff adherence to guidelines, resident health outcomes, quality of life, adverse events, satisfaction with care, or resource use. Study quality was assessed with the Cochrane Risk of Bias tool; evidence certainty was assessed using the GRADE approach. Results After screening 4367 citations, we identified 12 articles that included the results of 1 RCT and 11 cluster-RCTs. All included papers evaluated the effects of a champion as part of a multicomponent intervention. We found low certainty evidence that champions as part of multicomponent interventions may improve staff adherence to guidelines. Effect sizes varied in magnitude across studies including unadjusted risk differences (RD) of 4.1% [95% CI: − 3%, 9%] to 44.8% [95% CI: 32%, 61%] for improving pressure ulcer prevention in a bed and a chair, respectively, RD of 44% [95% CI: 17%, 71%] for improving depression identification and RD of 21% [95% CI: 12%, 30%] for improving function-focused care to residents. Conclusion Champions may improve staff adherence to evidence-based guidelines in LTC homes. However, methodological issues and poor reporting creates uncertainty around these findings. It is premature to recommend the widespread use of champions to improve uptake of guideline-based care in LTC without further study of the champion role and its impact on cost. Trial registration PROSPERO CRD42019145579. Registered on 20 August 2019.


Drugs & Aging ◽  
2018 ◽  
Vol 35 (7) ◽  
pp. 657-663 ◽  
Author(s):  
Jennifer K. Burton ◽  
Richard Papworth ◽  
Caroline Haig ◽  
Colin McCowan ◽  
Ian Ford ◽  
...  

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