This issue of Clinics in Geriatric Medicine, Guest Edited by Dr. Steven Castle, is devoted to Falls Prevention. Articles in this important issue include: Key components of exercise programs in community to prevent falls; Potential reasons deaths from falls in older adults have doubled in the past decade; Link between Primary care and community-based balance exercise programs; Role of foot orthoses and shoe insoles at improving mobility and balance; Blood Pressure control and falls risk; Optimizing function and physical activity in hospitalized older adults to prevent functional decline and falls; Delirium as it relates to falls; Virtual sitters; Redesigning a Fall Prevention Program in Acute Care: Building on Evidence; and Nursing Unit Design and Hospital Falls.
The WHO Falls Prevention for Active Ageing model provides an action plan for making progress in reducing the prevalence of falls in the older adult population. By building on the three pillars of falls prevention, the model proposes specific strategies for: 1. Building awareness of the importance of falls prevention and treatment; 2. Improving the assessment of individual, environmental, and societal factors that increase the likelihood of falls; and 3. For facilitating the design and implementation of culturally appropriate, evidence-based interventions that will significantly reduce the number of falls among older persons. The model provides strategies and solutions that will require the engagement of multiple sectors of society. It is dependent on and consistent with the vision articulated in the WHO Active Ageing Policy Framework. Although not all of the awareness, assessment, and intervention strategies identified in the model apply equally well in all regions of the world, there are significant evidence-based strategies that can be effectively implemented in all regions and cultures. The degree to which progress will be made depends on to the success in integrating falls prevention strategies into the overall health and social care agendas globally. In order to do this effectively, it is necessary to identify and implement culturally appropriate, evidence-based policies and procedures. This requires multi-sectoral, collaborations, strong commitment to public and professional education, interaction based on evidence drawn from a variety of traditional, complementary, and alternative sources. Although the understanding of the evidence-base is growing, there is much that is not yet understood. Thus, there is an urgent need for continued research in all areas of falls prevention and treatment in order to better understand the scope of the problem worldwide. In particular, more evidence of the cost-effectiveness of interconnections is needed to develop strategies that are most likely to be effective in specific setting and population sub-groups.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
"In both hospitals and long-term care facilities it's the older patients and residents who are most prone to falling and most vulnerable to serious injury from a fall. Staff must constantly be on the alert for hazardous situations and know how to deal with falls. This easy-to-read guide provides just the right amount of information needed by health care staff to prevent and manage this common problem among older adults." "This book presents a wealth of practical recommendations, modifications, equipment, and resources that will improve the health and safety of older adult patients and long-term care residents."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved
This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.
Since the first edition of this very successful book was written to synthesise and review the enormous body of work covering falls in older people, there has been an even greater wealth of informative and promising studies designed to increase our understanding of risk factors and prevention strategies. This second edition, first published in 2007, is written in three parts: epidemiology, strategies for prevention, and future research directions. New material includes recent studies covering: balance studies using tripping, slipping and stepping paradigms; sensitivity and depth perception visual risk factors; neurophysiological research on automatic or reflex balance activities; and the roles of syncope, vitamin D, cataract surgery, health and safety education, and exercise programs. This edition will be an invaluable update for clinicians, physiotherapists, occupational therapists, nurses, researchers, and all those working in community, hospital and residential or rehabilitation aged care settings.
4. EVIDENCE-BASED BEST PREACTICES FOR THE PREVENTION OF FALLS: 4.1 Existing practice guidelines ; 4.2 Best practices for fall prevention ; 4.3 Selecting appropriate approaches according to setting; 4.4 Recovery from a fall ;4.5 Factors influencing client compliance in fall prevention . 5. SUPPORTING FALL PREVENTION STRATEGIES. 6. THE WAY FORWARD; References; List of tables and figures; Appendix A: Risk factors for falls and fall-related ; Appendix B: List of the Public Health Agency of Canada's resources on seniors' falls.
This issue of Clinics in Geriatric Medicine features expert clinical reviews on Geriatric Emergency Medicine which includes current information on topics such as palliative medicine and emergency care, alternative management strategies, transitions of care, the emergency department observation unit and the older patient, generalized weakness, altered mental status, trauma management, acute pain management, acute visual changes, orthopedic emergencies, dizziness, palpitations, acute stroke syndromes, abuse and neglect, and electrolyte and endocrine emergencies.
