scholarly journals Risk of pressure injury among users of emergency care units

2020 ◽  
Vol 41 ◽  
Author(s):  
Danieli Parreira da Silva ◽  
Elaine Drehmer de Almeida Cruz ◽  
Josemar Batista ◽  
Aline Batista Maurício ◽  
Saimon da Silva Nazário ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
High Risk ◽  
Emergency Care ◽  
Cross Sectional ◽  
Braden Scale ◽  
Pressure Injury ◽  
Not At Risk ◽  
Spearman’S Correlation ◽  
Emergency Care Units

ABSTRACT Objective: To identify the risk of pressure injury in patients of emergency care units. Method: Descriptive, cross-sectional, and quantitative by applying the Braden scale to 377 patients from eight units in Paraná, between April and September 2016. Descriptive statistics and Spearman's correlation were used, with a significance of 0.1% for analysis. Results: There was a prevalence of risk-free patients (64.5%; n=243) and of older adults (54.6%; n=206); those at high risk for pressure injury were in the emergency department. Most of the variables were preserved, with emphasis on sensory perception (65.3%; n=246). The Spearman's correlation coefficient was at least 0.93 and indicated a strong linear relation between the results obtained in the variables and in the scale; it was verified that the risk for pressure injury increases with age. Conclusions: Most of the patients were not at risk; however, the older adults and those treated in the emergency department were at high risk of developing pressure injuries.

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 P118: Older adults in the emergency department: a retrospective cross-sectional study of the geriatric population in Edmonton emergency departments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S106-S107
Author(s):  
K. Morch ◽  
R. Schonnop ◽  
A. Gauri ◽  
D. Ha
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Geriatric Patient ◽  
Geriatric Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Region ◽  
Area Of Interest ◽  
Ed Visits

Introduction: The geriatric patient population accounts for an ever increasing proportion of emergency department (ED) visits. Geriatric centered EDs are an emerging area of interest and research. Though there have been past studies looking at older patient presentations at individual hospitals, there is limited data describing geriatric presentations within an entire Canadian geographic health region. This study characterizes the population of older adults utilizing the EDs in the Edmonton Zone, a health region that comprises a total of eleven tertiary (T), urban community (UC) and rural community (RC) hospitals. Methods: This retrospective cross-sectional study targeted all patients ≥65 years presenting to the Edmonton Zone EDs between April 1, 2017 to March 31, 2018. Data was extracted from the Emergency Department Information System (EDIS) database for ten EDs in the health region. Clinical and administrative data points were extracted and examined for each site. Results: We analyzed 100,813 ED geriatric patient visits during our study period, accounting for 18.7% of total ED visits to the Edmonton Zone. The five most common triage complaints at ED presentation were shortness of breath, abdominal pain, chest pain with cardiac features, general weakness, and back pain. CTAS scores 1-3 were assigned to 77.8% of geriatric presentations (T: 86.3%, UC: 77.4%, RC: 60.9%). 27.3% of geriatric patients had presented to an ED within the past 30 days (T: 30.0%, UC: 25.4%, RC: 27.7%). On average, 35.3% of older adult ED visits involved a consultation (T: 51.7%, UC 30.8%, RC 14.6%) and approximately 25% of geriatric patients were admitted to hospital during their ED visit (T: 42.8%, UC: 19.4%, RC: 7.1%). The average length of stay (LOS) in the ED (hh:mm) was 10:19 (T: 10:24, UC: 11:38, RC: 5:43). Overall, 2.4% of all geriatric patients left an ED without being seen after initial registration (T: 2.7%, UC: 2.2%, RC: 2.1%). Conclusion: Older adults represent a significant proportion of the ED visits in the Edmonton Zone. The triage acuity, LOS, re-presentation, consultation and admission rates varied based on the type of ED, which has implications for resource allocation within the health region. Our results can also direct future targeted initiatives and quality improvement projects to the various types of EDs in the Edmonton Zone, and facilitate planning of ED services for older adults in other health regions who have a similar geographic distribution of care sites.

scholarly journals Simple scoring algorithm to identify community-dwelling older adults with limited health literacy: a cross-sectional study in Taiwan

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e045411
Author(s):  
Wen-Hsuan Hou ◽  
Ken N Kuo ◽  
Mu-Jean Chen ◽  
Yao-Mao Chang ◽  
Han-Wei Tsai ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
High Risk ◽  
Health Information ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Scoring Algorithm ◽  
Community Dwelling Older Adults

ObjectiveHealth literacy (HL) is the degree of individuals’ capacity to access, understand, appraise and apply health information and services required to make appropriate health decisions. This study aimed to establish a predictive algorithm for identifying community-dwelling older adults with a high risk of limited HL.DesignA cross-sectional study.SettingFour communities in northern, central and southern Taiwan.ParticipantsA total of 648 older adults were included. Moreover, 85% of the core data set was used to generate the prediction model for the scoring algorithm, and 15% was used to test the fitness of the model.Primary and secondary outcome measuresPearson’s χ2 test and multiple logistic regression were used to identify the significant factors associated with the HL level. An optimal cut-off point for the scoring algorithm was identified on the basis of the maximum sensitivity and specificity.ResultsA total of 350 (54.6%) patients were classified as having limited HL. We identified 24 variables that could significantly differentiate between sufficient and limited HL. Eight factors that could significantly predict limited HL were identified as follows: a socioenvironmental determinant (ie, dominant spoken dialect), a health service use factor (ie, having family doctors), a health cost factor (ie, self-paid vaccination), a heath behaviour factor (ie, searching online health information), two health outcomes (ie, difficulty in performing activities of daily living and requiring assistance while visiting doctors), a participation factor (ie, attending health classes) and an empowerment factor (ie, self-management during illness). The scoring algorithm yielded an area under the curve of 0.71, and an optimal cut-off value of 5 represented moderate sensitivity (62.0%) and satisfactory specificity (76.2%).ConclusionThis simple scoring algorithm can efficiently and effectively identify community-dwelling older adults with a high risk of limited HL.

scholarly journals Ability of Older Adults to Report Elder Abuse: An Emergency Department–Based Cross‐Sectional Study

2020 ◽  
Vol 68 (1) ◽  
pp. 170-175
Author(s):  
Natalie L. Richmond ◽  
Sheryl Zimmerman ◽  
Bryce B. Reeve ◽  
Joseph A. Dayaa ◽  
Mackenzie E. Davis ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Elder Abuse ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Association between heart rate response during orthostatic test and falls in polymorbid patients aged 60 years and older

2019 ◽  
Vol 25 (4) ◽  
pp. 433-441
Author(s):  
A. V. Turusheva ◽  
Yu. V. Kotovskaya ◽  
E. V. Frolova
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
High Risk ◽  
Orthostatic Hypotension ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Vertical Position ◽  
Orthostatic Test ◽  
Cross Sectional ◽  
Risk Of Falls

Background. Orthostatic hypotension is a significant risk factor of falling in older adults. To diagnose the orthostatic hypotension an orthostatic test is used with assessment of heart rate (HR) response, systolic (SBP) and diastolic blood pressure (DBP) at the 3rd minute after the rise. However, according to studies, measurement of SBP and DBP at the 1st minute after rising can be more sensitive to detect older adults at risk of falling than at 3rd minute.Objective. The purpose of this study was to evaluate the role of changes in SBP, DBP and HR at the 1st, 2nd and 3rd minutes when performing an orthostatic test for identification of the elderly at high-risk of falls.Design and methods. This cross-sectional study included 100 adults aged 59+. Among them women comprise 56 % (n = 56). The following procedures were performed: the orthostatic test, anthropometry, medical history, assessment of drug treatment, depression evaluation, dementia and the degree of autonomy decline.Results. HR response at the 1st minute after the transition from horizontal to vertical position is more significant factor of falls risk than SBP and DBP changes during performing of orthostatic test. Absence of HR increasing during the transition from horizontal to vertical position associates with 10‑fold of risk falls among older adults: odds ratio 95 % confidence interval (OR 95 % CI) 10,5 (2,9–37,8). This association remained significant even after adjusting for age, gender, β-blockers use and comorbidity.Conclusion. Absence of HR increasing during the transition from horizontal to vertical position is a high sensitive marker of detecting older adults with polymorbidity in patients with the high risk of falls.

scholarly journals Stress in healthcare workers in Hospitals and Emergency Care Units in Sergipe public health service during COVID-19 pandemic time

2021 ◽  
Vol 17 (7) ◽  
Author(s):  
Aimée Obolari Durço ◽  
Diego Santos Souza ◽  
Isabella Barros Almeida ◽  
Lucas Sousa Sombrio ◽  
Márcio Roberto Viana Santos
Keyword(s):  
Public Health ◽  
Job Stress ◽  
Emergency Care ◽  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Assessment Model ◽  
Cross Sectional ◽  
Probabilistic Sampling ◽  
Physical Comfort ◽  
Emergency Care Units

The objective of this work was to assess the stress in healthcare workers (HCW) and its correlation with perception of stressors in their work environments - hospitals and emergency care units in the public health system in the state of Sergipe, Brazil, during the COVID-19 pandemic. This is a cross-sectional study carried out by non-probabilistic sampling with 58 HCW, using specific questionnaires and a validated scale (Job Stress Scale) about sociodemographic issues, job stress and COVID-19. Using the demand-control-support assessment model, the work performed was classified as passive, active, low strain and high strain, according work's demand and the range of decision-making freedom. Estimated correlations between each questionnaire were performed using Pearson's correlation coefficient through SPSS software, and descriptive statistics, through Excel. Most of the participants were shown to be under high psychological demand (93.10%) and found themselves with high control (89.66%). Some factors affected the HCW’s perception of social support in the workplace, these were their team’s knowledge about COVID-19, the availability of personal protective equipment, and their physical comfort while using it. HCW were involved in active work; although they were not in the worst scenario in relation to psychological stress, they were still under great psychological strain, which reinforces the need to adopt effective measures to reduce it.

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