scholarly journals Nursing diagnosis in older adults at risk for pressure injury

2021 ◽  
Vol 55 ◽  
Author(s):  
Eduarda de Quadros Morrudo Garcia ◽  
Bárbara Tarouco da Silva ◽  
Daiane Porto Gautério Abreu ◽  
Thicianne da Silva Roque ◽  
José Ismar dos Santos Sousa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
At Risk ◽  
Pressure Control ◽  
University Hospital ◽  
Cross Sectional ◽  
Care Plans ◽  
Nursing Diagnosis ◽  
Pressure Injury ◽  
Hospitalized Older Adults

ABSTRACT Objective: To develop nursing diagnoses and care plans for older adults with pressure injuries based on risk factors, aiming at preventing their occurrence in hospitalized older adults. Method: Exploratory, descriptive, cross-sectional, quantitative study conducted with 87 medical records at the Medical Clinic Unit of a University Hospital. Results: Among older adults at some risk for the development of pressure injury, there was a prevalence of the female sex, age over 80 years and moderate risk classification on the Braden Scale. Nursing interventions that encourage patient mobility, pressure control, skin supervision, nutrition, incontinence and hygiene stood out. Conclusion: Nursing has an important role in maintaining the integrity of patients’ skin. It is worth highlighting the use of injury predictive scales as a complement to clinical practice in order to assist in the nursing diagnosis with a view to interventions aimed at risk factors.

scholarly journals Capacidade funcional e resiliência em idosos hospitalizados

2018 ◽  
Vol 12 (6) ◽  
pp. 1500
Author(s):  
Luiza Rosa Bezerra Leão ◽  
Vitor Hugo Sales Ferreira ◽  
Andréa Mathes Faustino ◽  
Keila Cristianne Trindade da Cruz ◽  
Carla Targino Bruno dos Santos
Keyword(s):  
Older Adults ◽  
Functional Capacity ◽  
University Hospital ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Daily Life Activities ◽  
Sociodemographic Data ◽  
Rehabilitation Potential ◽  
Hospitalized Older Adults ◽  
Frequency Score

RESUMOObjetivo: identificar a capacidade funcional e a resiliência em idosos hospitalizados. Método: estudo quantitativo, transversal e descritivo realizado com 59 idosos internados em um hospital universitário. Aplicaram-se instrumentos de avaliação da capacidade funcional, resiliência e dados sociodemográficos. Resultados: constatou-se uma baixa resiliência em 28% dos idosos, média resiliência em 32% e alta resiliência em 39%. Entre os idosos mais independentes, o escore de maior frequência para a resiliência foi alto, enquanto os mais dependentes obtiveram escores de média a baixa resiliência. Conclusão: destaca-se a importância da realização da avaliação de resiliência e capacidade funcional como avaliação de rastreio em idosos, pois as baixas resiliência e capacidade funcional na avaliação inicial podem permitir a identificação de idosos com menor potencial de reabilitação e, assim, favorecer um melhor planejamento da alta pelos profissionais de saúde e uma alta hospitalar precoce. Descritores: Idoso; Resiliência Psicológica; Avaliação em Saúde; Assistência a Idosos; Saúde do Idoso; Atividades Cotidianas.ABSTRACTObjective: to determine functional capacity and resilience in hospitalized older adults. Method: quantitative, cross-sectional and descriptive study conducted with 59 older adults admitted to a university hospital. We used instruments to assess functional capacity, resilience, and sociodemographic data. Results: low resilience (28%), medium resilience (32%), and high resilience (39%) were found in the older adults. Among the most independent older adults, the highest frequency score for resilience was high, whereas the scores of the most dependent older adults ranged from medium to low. Conclusion: it is important to assess resilience and functional capacity to screen older adults, given that low resilience and functional capacity in the initial evaluation can allow the identification of older adults with less rehabilitation potential and, thus, favoring better planning of discharge by health professionals and early hospital discharge. Descriptors: Older Adult; Psychological Resilience; Health Evaluation; Healthcare in Older Adults; Health of Older Adults; Daily Life Activities.  RESUMENObjetivo: identificar la capacidad funcional y la resiliencia en personas mayores hospitalizadas. Método: estudio cuantitativo, transversal y descriptivo realizado con 59 personas mayores internadas en un hospital universitario. Se utilizaron instrumentos de evaluación de la capacidad funcional, resiliencia y datos sociodemográficos. Resultados: se constató una baja resiliencia en el 28% de las personas mayores, media resiliencia en el 32% y alta resiliencia en el 39%. Entre las personas mayores más independientes, el score de mayor frecuencia para la resiliencia fue alto, mientras que las más dependientes obtuvieron escores de media a baja resiliencia. Conclusión: se destaca la importancia de realizar la evaluación de resiliencia y capacidad funcional para evaluar personas mayores, pues las bajas resiliencia y capacidad funcional en la evaluación inicial pueden permitir la identificación de personas mayores con menor potencial de rehabilitación y así favorecer una mejor planificación del alta por los profesionales de salud y alta hospitalaria precoz. Descriptores: Persona Mayor; Resiliencia Psicológica; Evaluación en Salud; Asistencia en Personas Mayores; Salud de la Persona Mayor; Actividades Cotidianas.  

scholarly journals Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study

2021 ◽  
Vol 7 ◽  
pp. 237796082110261
Author(s):  
Annelie K. Gusdal ◽  
Rose-Marie Johansson-Pajala ◽  
Marina Arkkukangas ◽  
Anna Ekholm ◽  
Viktoria Zander
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
At Risk ◽  
Residential Care ◽  
Care Staff ◽  
Registry Study ◽  
Educational Training ◽  
Cross Sectional ◽  
National Quality ◽  
Risk Factors For Falls

Introduction Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.

scholarly journals Occurrence of pressure injury in patients hospitalized in a school hospital

2018 ◽  
Author(s):  
Juliana Barbosa ◽  
Geraldo Salomé
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Emergency Room ◽  
University Hospital ◽  
Medical Clinic ◽  
Moderate Risk ◽  
Cross Sectional ◽  
Braden Scale ◽  
Pressure Injury ◽  
Surgical Clinic

Objective: to evaluate the occurrence and risk factors for the development of pressure injury (PI) in patients admitted in medical and surgical clinics and in observation at the emergency room of a university hospital. Methods: Cross-sectional, descriptive-exploratory, epidemiological study. Patients were assessed by physical examination three times a week for two consecutive months between June and November 2016. Results: the frequency of PI was 29% (n = 9) in the medical clinic, 16% (n = 4) in the surgical clinic and 53.8% (n = 7) in observation at the emergency room. According to the Braden scale, seven (30.4%) patients in the medical clinic presented high risk and two (25%) moderate risk; three (27.3%) patients from the surgical clinic presented a high risk and one (7.1%) moderate risk; and seven (58.3%) patients in observation at the emergency room were high risk. The risk factors associated with the participants who developed PI were: restriction in the bed, use of catheters or devices, vasoactive drug, diaper, mechanical ventilation, sedatives, unconsciousness, food fasting and hospitalization time over 10 days. Conclusion: there was a high frequency of PI in the medical and surgical clinics and in observation at the emergency room. Most patients were high risk for developing PI.

scholarly journals Nursing care mapping for patients at risk of falls in the Nursing Interventions Classification

2014 ◽  
Vol 48 (4) ◽  
pp. 632-640 ◽  
Author(s):  
Melissa de Freitas Luzia ◽  
Miriam de Abreu Almeida ◽  
Amália de Fátima Lucena
Keyword(s):  
At Risk ◽  
Nursing Care ◽  
Cross Sectional Study ◽  
Mapping Method ◽  
University Hospital ◽  
Nursing Interventions ◽  
Cross Sectional ◽  
Nursing Diagnosis ◽  
Risk Of Falls ◽  
Patients At Risk

Objective: Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). Method: A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. Results: The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients’ belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. Conclusion: The treatment prescribed in clinical practice was corroborated by the NIC reference.


scholarly journals Incorporating foot assessment in the comprehensive geriatric assessment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca K. Iseli ◽  
Gregory Duncan ◽  
Elton K. Lee ◽  
Ellen Lewis ◽  
Andrea B. Maier
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
At Risk ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Disease Risk ◽  
Arterial Disease ◽  
Foot Deformity ◽  
Hospitalized Older Adults ◽  
Foot Disease

Abstract Background Foot problems are common in older adults and associated with poorer physical function, falls, frailty and reduced quality of life. Comprehensive Geriatric Assessment (CGA), a multidisciplinary process that is considered the gold standard of care for older adults, does not routinely include podiatry assessment and intervention in hospitalized older adults. Aims To introduce foot assessment to inpatient CGA to determine prevalence of foot disease, foot disease risk factors and inappropriate footwear use, assess inter-rater reliability of foot assessments, determine current podiatry input and examine associations between patient characteristics and foot disease risks. Methods Prospective, observational cohort study of older adults on geriatric rehabilitation wards. Foot assessment completed using the Queensland Foot Disease Form (QFDF) in addition to routine CGA. Results Fifty-two patients (median age [inter-quartile range] 86.4 [79.2–90.3] years, 54% female) were included. Six patients (12%) had foot disease and 13 (25%) had a ‘high risk’ or ‘at risk’ foot. Foot disease risk factor prevalence was peripheral arterial disease 9 (17%); neuropathy 10 (19%) and foot deformity 11 (22%). Forty-one patients (85%) wore inappropriate footwear. Inter-rater agreement was substantial on presence of foot disease and arterial disease, fair to moderate on foot deformity and fair on neuropathy and inappropriate footwear. Eight patients (15%) saw a podiatrist during admission: 5 with foot disease, 1 ‘at risk’ and 2 ‘low risk’ for foot disease. Patients with an at risk foot or foot disease had significantly longer median length of hospital stay (25 [13.7–32.1] vs 15.2 [8–22.1] days, p = 0.01) and higher median Malnutrition Screening Test scores (2 [0–3] vs 0 [0–2], p = 0.03) than the low-risk group. Patients with foot disease were most likely to see a podiatrist (p < 0.001). Conclusion Foot disease, foot disease risk factors and inappropriate footwear are common in hospitalized older adults, however podiatry assessment and intervention is mostly limited to patients with foot disease. Addition of routine podiatry assessment to the multidisciplinary CGA team should be considered. Examination for arterial disease and risk of malnutrition may be useful to identify at risk patients for podiatry review.

Health Concerns of Older Adults: Observations from a Survey and Public Education Programme in Bhubaneswar, India

2019 ◽  
Vol 15 (1) ◽  
pp. 10-16
Author(s):  
Shreyan Kar ◽  
Tushar Kanti Das ◽  
Prasanta Kumar Mohapatra ◽  
Brajaballav Kar ◽  
Anupama Senapati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Mood State ◽  
Physical Symptoms ◽  
Considerable Proportion ◽  
Cardiovascular Risks ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Concerns

Background: While it is apparent that old age is associated with multiple health concerns, the extent of its multiplicity and burden is often not clear. It was intended to find out self-reported health concerns for one month and cardiovascular risk factors in middle and older adults. Methods: In the cross-sectional survey, attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of a cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of older adults had a range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4), and for females 10.3% (±6.6) (p<0.05). On average, the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk of participants was 2.1 for males and 1.5 for females for heart attack or stroke within the ten years, compared to healthy persons. The symptoms and risk factors were elicited easily, and the process probably facilitated improving the awareness about the health concerns holistically. The survey also identified issues related to the engagement of older adults in the existing health care systems. Conclusions: The results suggested that questionnaire-based health screening in a community can identify a range of health concerns and identify multi-morbidity in general and cardiovascular risks in particular. This process may help to focus on the appropriate public health awareness and intervention programmes required in the community.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals Assessing burden, risk factors, and perceived impact of uterine fibroids on women’s lives in rural Haiti: implications for advancing a health equity agenda, a mixed methods study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Christophe Millien ◽  
Anatole Manzi ◽  
Arlene M. Katz ◽  
Hannah Gilbert ◽  
Mary C. Smith Fawzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mixed Methods ◽  
Black Women ◽  
Uterine Fibroids ◽  
Mixed Methods Study ◽  
University Hospital ◽  
Gynecologic Surgery ◽  
Cross Sectional ◽  
Women's Lives

Abstract Background Uterine fibroids, the most common cause of gynecologic surgery, have a reported cumulative incidence of 59% among Black women in the U.S. Uterine fibroids negatively impact the quality of women’s lives. No study has been found in the literature about fibroids in Haiti. We conducted a mixed methods study to assess the burden and risk factors of uterine fibroids, as well as their effects on women’s quality of life. Methods A convergent mixed methods study was conducted between October 1, 2019 and January 31, 2020 at MUH’s (Mirebalais University Hospital) OB-GYN outpatient department. Quantitatively, in a cross-sectional study 211 women completed consecutively a structured questionnaire. In-depth interviews with 17 women with fibroids and 7 family members were implemented for the qualitative component. Descriptive statistics were calculated for clinical and social demographic variables. Logistic regression was performed to examine associations between fibroids and related risk factors. An inductive thematic process was used to analyze the qualitative data. A joint display technique was used to integrate the results. Results Of 193 women analyzed 116 had fibroids (60.1%). The mean age was 41.3. Anemia was the most frequent complication— 61 (52.6%). Compared to women without uterine fibroids, factors associated with uterine fibroids included income decline (AOR = 4.7, 95% CI: 2.1–10.9, p = < 0.001), excessive expenses for transport (AOR = 4.4, 95% CI: 1.6–12.4, p = 0.005), and family history with uterine fibroids (AOR = 4.6, 95% CI: 1.6–13.6, p = 0.005). In contrast, higher level of education and micro polycystic ovarian syndrome were associated with lower prevalence (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.021) and (AOR = 0.2, 95% CI: 0.1–0.97, p = 0.044), respectively. The qualitative findings delineate how contextual factors such as health system failures, long wait times, gender inequality and poverty negatively affect the quality of women’s lives. The poverty cycle of uterine fibroids emerged. Conclusions A vicious cycle of poverty negatively impacts access to care for uterine fibroids in Haiti. Health insurance, social support, and income generating activities may be keys to promote social justice through access to adequate care for women with uterine fibroids in Haiti.

scholarly journals Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1557
Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Hours ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Burnout Syndrome ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Associated ◽  
Resident Physicians ◽  
Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

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