scholarly journals Fatores extrínsecos para risco de quedas de idosos hospitalizados

2018 ◽  
Vol 12 (7) ◽  
pp. 1835
Author(s):  
Bárbara Jeane Pinto Chaves ◽  
Jacira Dos Santos Oliveira ◽  
Mayara Muniz Peixoto Diniz ◽  
Renata Maia de Medeiros Falcão ◽  
Suzanna Valeria Oliveira de Souza ◽  
...  

RESUMO Objetivo: identificar os fatores extrínsecos favoráveis à ocorrência de quedas de pacientes idosos hospitalizados. Método: estudo quantitativo, documental, retrospectivo e descritivo realizado a partir da coleta de registros no livro de admissão e alta dos pacientes internados na unidade de clínica cirúrgica de um Hospital Universitário. A amostra reuniu 424 idosos internados no período de janeiro a dezembro de 2015. Os dados foram digitados no Excel e analisados no Programa SPSS, versão 2.0., e os resultados, apresentados em tabelas. Resultados: o perfil dos idosos mostrou maioria para o sexo feminino 227 (54%), uma média de idade 71,6 anos, com maiores números de internamento em fevereiro 55 (13%), média de tempo de 4,8 dias e motivo da saída 351 (83%) por alta hospitalar. Consideraram-se oito (62%) enfermarias como ambientes seguros, embora quatro (31%) enfermarias tinham excesso de móveis. Conclusão: conhecer o perfil dos idosos e os fatores extrínsecos possibilitará, aos profissionais de saúde, identificar os riscos e prover a assistência segura ao idoso. Descritores: Idoso; Hospitalização; Acidentes por quedas; Assistência de Enfermagem; Envelhecimento; Fatores de Risco.ABSTRACT Objective: to identify the extrinsic factors favorable to the occurrence of falls in hospitalized elderly patients. Method: quantitative, documental, retrospective and descriptive study carried out from the collection of records in the admission and discharge book of the patients hospitalized in the unit of surgical clinic of a University Hospital. The sample consisted of 424 elderly hospitalized from January to December 2015. The data were entered in Excel and analyzed in the SPSS Program, version 2.0., And the results, presented in tables. Results: the profile of the elderly showed a majority of females 227 (54%), mean age 71.6 years, with higher admission numbers in February 55 (13%), mean time of 4.8 days and motive of exit 351 (83%) due to hospital discharge. Eight (62%) wards were considered safe environments, although four (31%) wards had excess furniture. Conclusion: knowing the profile of the elderly and the extrinsic factors will enable health professionals to identify the risks and provide safe care for the elderly.  Descriptors: Aged; Hospitalizacion; Accidental Falls; Nursing Care; Aging; Risk Factors,RESUMEN Objetivo: identificar los factores extrínsecos favorables a la ocurrencia de caídas de pacientes ancianos hospitalizados. Método: estudio cuantitativo, documental, retrospectivo y descriptivo realizado a partir de la recolección de registros en el libro de admisión y alta de los pacientes internados en la unidad de clínica quirúrgica de un Hospital Universitario. La muestra se reunió 424 ancianos internados en el período de enero a diciembre de 2015. Los datos fueron digitados en Excel y analizados en el Programa SPSS, versión 2.0, y los resultados, presentados en tablas. Resultados: el perfil de los ancianos mostró la mayoría para el sexo femenino 227 (54%), una media de edad 71,6 años, con mayores números de internamiento en febrero 55 (13%), y media de tiempo de 4,8 días y motivo de la salida 351 (83%) por alta hospitalaria. Se consideraron ocho (62%) enfermeras como ambientes seguros, aunque cuatro (31%) de las enfermerías tenían exceso de muebles. Conclusión: conocer el perfil de los ancianos y los factores extrínsecos, posibilitar, a los profesionales de salud, identificar los riesgos y proveer la asistencia segura al anciano. Descriptores: Anciano; Hospitalizaciòn; Accidentes por Caídas; Atencion de Enfermarìa; Envejecimiento; Factores de Riesgo.

Author(s):  
Sergio Vital da Silva Junior ◽  
Terezinha Nunes da Silva ◽  
Maria Eliane Moreira Freire ◽  
Lucas Barreto Pires Santos

Objetivo: Investigar a compreensão de enfermeiros assistenciais sobre cuidados paliativos à pessoa idosa hospitalizada,apontando os desafios enfrentados na prática assistencial. Metodologia: Estudo exploratório, com abordagem qualitativa,desenvolvido com 10 (dez) enfermeiros atuantes em um hospital universitário, tendo sido respeitados todos os procedimentos éticos. Resultado: A investigação permitiu identificar 3 categorias discursivas relacionadas à assistência de enfermagem a idosos em cuidados paliativos: a compreensão de enfermeiros assistenciais sobre cuidados paliativos, as ações deenfermagem direcionadas ao idoso em cuidados paliativos e os desafios vivenciados pelos enfermeiros ao cuidar de idososem atenção paliativa. Conclusão: Este estudo oportunizou reconhecer a compreensão de enfermeiros sobre cuidadospaliativos à pessoa idosa hospitalizada, apontando quais os desafios enfrentados na prática assistencial.Palavras-chave: Enfermagem; Cuidados Paliativos; Idoso. ABSTRACTObjective: To investigate the understanding of nursing assistants on palliative care for hospitalized elderly persons, pointingout the challenges faced in care practice. Methodology: An exploratory study, with a qualitative approach, developed with10 (ten) nurses working in a university hospital, and all ethical procedures were respected. Results: The research allowedidentifying three discursive categories related to nursing care for the elderly in palliative care: the understanding of nursingassistants on palliative care, nursing actions directed to the elderly in palliative care and the challenges experienced bynurses in caring for the elderly in palliative care. Conclusion: This study made it possible to recognize nurses’ understandingof palliative care for hospitalized elderly people, pointing out the challenges faced in care practice.Keywords: Nursing; Palliative care; Old man.


2018 ◽  
Vol 21 (1) ◽  
pp. 35-43
Author(s):  
Barbara Martins Corrêa da Silva ◽  
Célia Pereira Caldas ◽  
Helena Maria Shchelowski Leal David ◽  
Michel Jean Marie Thiollent

Abstract Objective: to analyze the proposal of an action plan created by nurses to deal with difficulties in caring for the elderly. The aim of the present study was therefore to analyze the difficulties that family caregivers find in relation to access to services, material resources and the support network when meeting the care needs of the elderly in accordance with Brazilian public policy. Method: the methodology of participatory research and content analysis proposed by Bardin was used. The context was the Geriatric service of a university hospital. The group of co-researchers included eight nurses and 12 caregivers of elderly people with dementia. Results: the following categories emerged from the analysis: contradictions and work proposals. The contradictions category revealed reflections about the difference between the proposed care for the elderly and the reality of a lack of care and the precarious conditions of health services. This situation leads to overburdening of caregivers. The work proposals refer to the strategies used by nurses to establish a relationship of support to family caregivers to cope with the difficulties involved in care for the elderly. Conclusion: nurses recognize that they are professionals capable of receiving, listening to and managing the needs of family caregivers of the elderly, thus promoting the health of the elderly and the caregivers themselves, preparing the family of the patient for home care and coping with difficulties experienced in elderly care.


2016 ◽  
Vol 23 (8) ◽  
pp. 998-1004 ◽  
Author(s):  
Nevine A. Kassim ◽  
Tamer M. Farid ◽  
Shaimaa Abdelmalik Pessar ◽  
Salma A. Shawkat

A rapid and accurate diagnosis of venous thromboembolism (VTE) in the elderly individuals represents a dilemma due to nonspecific clinical presentation, confusing laboratory results, and the hazards of radiological examination in this age-group. d-Dimer test is used mainly in combination with non-high clinical pretest probability (PTP) to exclude VTE. d-Dimer testing retains its sensitivity, however, its specificity decreases in the elderly individuals. Raising the cutoff level improves the specificity of the d-dimer test without compromising its sensitivity. The current study aimed to explore the reliability of higher d-dimer cutoff values for the diagnosis of asymptomatic VTE in a population of bedridden hospitalized elderly patients with non-high clinical PTP. This retrospective study included 252 bedridden hospitalized elderly patients (>65 years) who were admitted to the Ain shams University Specialized Hospital with non-high clinical probability and developed later reduced mobility; all underwent quantitation of d-dimer and Doppler examination. Considering the whole population (>65 years), the age-adjusted cutoff achieved the best performance in comparison with the conventional and receiver operating characteristic (ROC)–derived cutoffs. When stratified according to age, the age-adjusted cutoff showed the best performance in the age-group 65-70 and comparable performance with the ROC-derived cutoff in the age-group 71-80, however, its sensitivity compromised in those older than 80 years. In conclusion, it is recommended to use age-adjusted cutoff value of d-dimer together with the clinical probability score in elderly individuals (65-80 years).


2009 ◽  
Vol 4 (1) ◽  
pp. 34
Author(s):  
Gilson De Vasconcelos Torres ◽  
Lucila Corsino de Paiva ◽  
Manuela Pinto Tibúrcio ◽  
Isabelle Katherinne Fernandes Costa ◽  
Gabriela De Sousa Martins Melo ◽  
...  

ABSTRACTObjective: to examine the association between predisposing conditions (CP), intrinsic (FI) and extrinsic factors (EF) with occurrence of PU in bedridden patients in the intensive care unit and wards of a university hospital. Metodology: it’s a descriptive and quantitative study, performed at a University Hospital from Natal/RN city, after approved by the Ethics Committee of Hospital Universitário Onofre Lopes (protocol number135/07) in which data were collected from December 2007 to February 2008, through a structured form, data from medical records and physical examination of the skin. The results were organized using SPSS 15.0 and analyzed using descriptive and inferential statistics. Results: of the 30 patients studied, were diagnosed in 19 UP 43.3% of them. Was found an association of 35.7% of the Predisposing conditions, Intrinsic factors and Extrinsic factors for all patients studied, statistically significant (p-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation (r=0618) in the presence of this association. Conclusion: results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on. Descriptors: pressure ulcer; risk factors; incidence; hospital care; nursing. RESUMOObjetivo: analisar a associação entre condições predisponentes (CP), fatores intrínsecos (FI) e fatores extrínsecos (FE) com a ocorrência de úlcera de pressão (UP), em pacientes acamados em Unidade de Terapia Intensiva e enfermarias de um hospital universitário. Metodologia: estudo descritivo, com abordagem quantitativa, realizado em um hospital universitário em Natal/RN. Após aprovação do Comitê de Ética do Hospital Universitário Onofre Lopes (número de protocolo 135/07) os dados foram coletados por meio de um formulário estruturado, dados dos prontuários e exame físico da pele no período de dezembro de 2007 a fevereiro de 2008. Os resultados foram organizados no programa SPSS 15.0 e analisados por meio de estatística descritiva e inferencial. Resultados: dos 30 pacientes, foram diagnosticadas 19 UP em 43,3% deles. Verificou-se associação de 35,7% das Condições Predisponentes, Fatores Intrínsecos e Fatores Extrínsecos, estatisticamente significante (p-valor = 0,001), entre as médias dos escores nos pacientes com e sem UP, com razão de chance de 12,0 de desenvolvimento de UP e existência de moderada correlação (r = 0,618) na presença dessa associação. Conclusão: denotou-se a influência de múltiplos fatores e condições na ocorrência de UP, o que leva à reflexão acerca da assistência voltada para prevenção dessas lesões. Descritores: úlcera de pressão; fatores de risco; incidência; assistência hospitalar; enfermagem. RESUMENObjetivo: examinar la asociación entre condiciones predisponentes (CP), factores intrínseco (FI) y factores extrínsecos (FE) en la aparición de úlceras por presión (UPP) en los pacientes postrados en cama en la unidad de cuidados intensivos y salas de un Hospital Universitario. Métodos: estudio descriptivo y cuantitativo realizado en el Hospital Universitario de Natal/RN. Después de la aprobación por el Comité de Ética del Hospital Universitário Onofre Lopes (número de registro 135/07) se recogieron los datos durante el período comprendido entre diciembre 2007 a febrero 2008, a través de cuestionario estructurado, los registros médicos y el examen físico de la piel. Resultados: de los 30 pacientes fueron diagnosticados en 19 UP hasta el 43,3% de ellos. Una asociación de 35,7% de condiciones predisponentes, factores intrínseco y factores extrínsecos, estadísticamente significativa (p = 0,001) entre las puntuaciones medias en los pacientes con y sin UP, con una rasión de chance de 12,0 para el desarrollo de la UP y hay una correlación moderada (r = 0,618) en presencia de esta asociación de. Conclusión: se denoto la influencia de la multiplicidad de factores y condiciones sobre la presencia de PU, que conduce a la comprensión de la atención se centró en la prevención de estas lesiones. Descriptores: úlcera por presión; factores de riesgo; epidemiología; atención hospitalaria; enfermería. 


Author(s):  
Lina K. Massoud ◽  
Hala Z. AlAgha ◽  
Mahmoud H. Taleb

Inappropriate prescribing (IP) is a major healthcare problem in elderly patients. The risk of this problem increases during hospitalization. This is due to increase morbidity and thus increases the use of medications by the inpatients. This study will clarify the problem of IP for elderly people during hospitalization and will identify the different types of it. It also will highlight some tools that are used to assess the different types of IP and the prevalence of it in elderly patients during hospitalization. Finally, the study will address the consequences of IP in the elderly inpatients and the risks associated with the use of some potentially inappropriate medications (PIMs) in the elderly. 


2011 ◽  
Vol 5 (5) ◽  
pp. 1223 ◽  
Author(s):  
Virna De Vasconcelos Batista ◽  
Elaine Guedes Fontoura ◽  
Darci De Oliveira Santa Rosa

ABSTRACTObjective: to get to know the meaning of the care provided by nursing staff in the vision of hospitalized elderly patients at the clinic of a public hospital. Methodology: qualitative research, conducted from January to March of 2009 with ten elders of both sexes hospitalized in the medical clinic at a public hospital in the city of Feira de Santana, Bahia. The data collection instrument was a semi-structured recorded interview. Data analysis was made by the method of thematic content analysis. The study was approved by the Ethical Committee of the Faculdade de Tecnologia e Ciências, resolution no. 0589-2008. Results: two themes emerged from the testimonies: the meaning of care in the vision of elderly and the positive and negative aspects of care received by nursing staff. The elderly have a positive view of care received by nursing staff relating to dedication, love and humanization. Regarding the negative aspects of care received, they relate: lack of communication and information about their health state. Conclusion: because it is a fragile stage of life, elderly people require special attention, sensitive care by the nursing staff. Descriptors: care; elderly; hospital; medical clinic; nursing.RESUMOObjetivo: conhecer o significado do cuidado prestado pela equipe de enfermagem na visão dos idosos internados na clínica médica de um hospital público. Metodologia: pesquisa qualitativa, realizada de janeiro a março de 2009 com dez idosos de ambos os sexos internados na clínica médica de um hospital público da cidade de Feira de Santana, Bahia. O instrumento de coleta de dados foi uma entrevista semi-estruturada, gravada. A análise dos dados foi realizada pelo método de análise de conteúdo temática. O estudo foi aprovado pelo Comitê de Ética da Faculdade de Tecnologia e Ciências pelo parecer nº 0589-2008. Resultados: dos depoimentos emergiram duas categorias temáticas: o significado do cuidado na visão dos idosos e os aspectos positivos e negativos do cuidado recebido pela equipe de enfermagem. Os idosos têm visão positiva do cuidado recebido pela equipe de enfermagem relacionando a dedicação, humanização e amor. Quanto aos aspectos negativos do cuidado recebido referem: falta de comunicação e informações sobre o seu estado de saúde. Conclusão: por se tratar de uma fase de fragilidade da vida a pessoa idosa requer uma atenção especial, um cuidado sensível pela equipe de enfermagem. Descriptores: cuidado; idosos; hospital; clínica médica; enfermagem.RESUMENObjetivo: conocer el significado del cuidado ofrecido por el equipo de enfermería en la visión de mayores internados en clínica médica de un hospital público. Metodología: investigación cualitativa, realizada de enero a marzo de 2009 con diez mayores de ambos sexos internados en clínica médica de un hospital público de la ciudad de Feira de Santana, Bahia. La  recolecta de datos fue através de entrevista semiestructurada y grabada. El análisis de datos fue realizado por el método de análisis de contenido temático. El estudio fue aprobado Comité Ética Facultad de Tecnología y Ciencias con el parecer nº 0589-2008. Resultados: de los testimonios emergieron dos categorias temáticas: significado del cuidado en la visión de los mayores y los aspectos positivos y negativos del cuidado recibido por el equipo de enfermería. Los mayores tienen una visión positiva del cuidado recibido por el equipo de enfermería relacionando dedicación, humanización y amor. Cuanto a los aspectos negativos del mismo refieren: falta de comunicación e informaciones sobre su estado de salud. Conclusión: tratándose de una fase de fragilidad de la vida, la persona mayor requiere una atención especial y  cuidado sensible por el equipo de enfermería. Descriptores: cuidado; mayores; hospital; clínica médica; enfermería.


2012 ◽  
Vol 27 (8) ◽  
pp. 609-613 ◽  
Author(s):  
P. Mendiratta ◽  
J. M. Tilford ◽  
P. Prodhan ◽  
K. Curseen ◽  
G. Azhar ◽  
...  

Objectives: To investigate national trends in percutaneous endoscopic gastrostomy (PEG) tube placement for hospitalized elderly patients from 1993to 2003. Methods: Retrospective analysis of patients ≥65 years of age with PEG tube placement from 1993 to 2003 from the Nationwide Inpatient Sample (NIS) database was utilized to calculate PEG placement rates per 1000 people. Results: Placement of PEG tube increased by 38% in elderly patients during the study period, from 2.71 procedures during hospitalization per 1000 people to 3.75 procedures during hospitalization per 1,000 people. Placement of PEG tube in patients with Alzheimer’s dementia doubled (5%-10%) over the study period. Conclusion: Over a 10-year period, PEG tube use in hospitalized elderly patients increased significantly. More importantly, approximately 1 in 10 PEG tube placements occurred in patients with dementia.


1995 ◽  
Vol 29 (4) ◽  
pp. 354-358 ◽  
Author(s):  
Barry J Gales ◽  
Susan M Menard

Objective: To examine the relationship between administration of selected medications and falls experienced by hospitalized elderly patients. Benzodiazepines and other medications previously associated with falls in elderly patients residing in the community and nursing homes were the primary focus. Design: Retrospective case control. Setting: Private, not-for-profit, 575-bed acute care hospital. Participants: A total of 100 patients who had fallen and 100 control patients, aged at least 70 years, admitted during the same 17-month time period. Main Outcome Measures: We examined the relationship between falls and patient demographics, underlying disease states, number of concurrent disease states, and length of hospitalization. Possible associations between the administration of narcotics, benzodiazepines, antidepressants, antipsychotics, other sedating agents, antihypertensives, diuretics, nitrates, and digoxin 48 hours prior to the fall or reference day were explored. The relationships between benzodiazepine half-life, dosage, administration frequency, cumulative dose, and falls were also examined. Results: Demographically the groups were similar except that patients who had fallen were hospitalized significantly longer (mean 18.8 vs 12.2 d; p < 0.00001) than control patients. Benzodiazepines were received by more (40% vs 20%, odds ratio = 2.67) patients who had fallen than control patients. The use of long (>24 h) half-life benzodiazepines was similar in patients who had fallen (48%) and control patients (45%). Long half-life benzodiazepines were commonly administered (65%) to patients who had fallen in doses greater than that recommended for the elderly. Benzodiazepine use, expressed as milligrams of diazepam equivalents received during the 48-hour study, was higher in patients who had fallen than in control patients (15.00 ± 17.80 vs 9.73 ± 6.58 mg), but this was not statistically significant (p = 0.1030). Congestive heart failure (37% vs 24%), digoxin therapy (35% vs 22%), or administration of 3 or more psychoactive agents (17% vs 4%) were all more common in patients who had fallen than in control patients. Conclusions: Falls experienced by the elderly patients in our acute care institution were associated with the presence of congestive heart failure along with digoxin therapy, benzodiazepine use, or the use of at least 3 psychoactive agents.


2017 ◽  
Vol 11 (3) ◽  
pp. 4-9
Author(s):  
Grażyna Puto ◽  
Iwona Repka ◽  
Kornelia Biłko ◽  
Mirosława Dzikowska

Background: Health-related behaviours affect the preservation and maintenance of health. They form a important part of the everyday life of all individuals including the elderly. Some of the most significant factors affecting health are eating habits, physical activity, and the ability to handle stress and limiting the use of substances. Aim of the study: The aim of this paper was to assess the effect of health-related behaviours on nutrition in hospitalized elderly patients. Material and Methods: The study population consisted of 151 subjects over 60 years old. The study tools included a diagnostic survey, the Health Behaviour Inventory and the Mini Nutritional Assessment. Statistical significance for differences and strength of correlation between the variables was set at p<0.05. Results: The general indicator of health behaviour was higher among women (88.78±13.82 vs. 83.55±12.93; p=0.01). The analysis of health behaviour showed significant differences between men and women in relation to good eating habits (p=0.01) and prophylactic behaviour (p=0.01). Conclusions: Elderly people who followed a proper diet, which included fruit and vegetables, and avoided food with preservatives, were better nourished. A positive attitude was connected with the state of nutrition. Wellnourished status can be observed among the elderly who have positive attitude, avoid anger, anxiety and depression, and have friends and a stable family life.


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