Search

Measuring lying and standing blood pressure (BP) is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. In a recent snapshot audit in England and Wales of 179 acute hospitals and 4,846 patients aged 65 years and over admitted with an acute illness, only 16% had a lying and standing BP recorded within 48 hours. A review of the literature showed that existing advice on how to measure and interpret lying and standing BP was often not appropriate for use on the ward with frail and unwell inpatients. An online survey of 275 clinicians' usual practice highlighted variation and the need for clarity and pragmatism. In the light of the survey findings, a clinical guide has been developed on when to measure lying and standing BP, how to measure it and what is considered a significant result. [ABSTRACT FROM AUTHOR]

Background: The ageing population is generating increasing concern over the occurrence and associated costs of falls in healthcare settings. Supplementary to the investigation of strategies to prevent falls, is the consideration of ways to reduce the number of injuries resulting from falls in these settings. Aims: This overview assesses the status of research on flooring in healthcare settings to reduce the incidence of injury resulting from falls. Methods: A comprehensive literature search, carried out in conjunction with a Cochrane Systematic Review on hospital environments for patient health-related outcomes, identified the available evidence. Searches were also conducted in Medline and Scopus specifically to identify studies on flooring types, falls, and injuries. Reference lists of relevant studies and reviews were scanned and relevant authors were approached for further information. Conclusions: Flooring should be considered as a possible intervention for reducing injuries from falls, however, more rigorous and higher quality research is needed to identify the most appropriate materials for use. [ABSTRACT FROM AUTHOR]

Falls are an issue disproportionately affecting older people who are at increased risk of falls and injury. This protocol describes a pilot study investigating shock-absorbing flooring for fall-related injuries in wards for older people. OBJECTIVES: To inform future research by evaluating fall-related injuries on the intervention and existing flooring, assessing the sustainability of the flooring in ward environments, estimating the cost-effectiveness of the floor and assessing how the floor affects patients and other users. DESIGN: This study uses mixed methods: a pilot cluster randomised controlled trial, observation via mechanical testing and interviews. Eight participating wards (clusters) are randomised using a computer-generated list. No blinding is incorporated into the study. Each site has a baseline period of approximately 6 months. Then, four sites receive the intervention floor, while four continue using standard floors. Sites are then followed up for approximately 1 year. PARTICIPANTS: Any person admitted to a bed in the ‘study area’ of a participating ward can be entered into the trial. Orientated patients, visitors and any hospital staff who use the floor in a study area are eligible for inclusion in an interview. INTERVENTION: An 8.3 mm thick vinyl floor covering with polyvinyl chloride foam backing (Tarkett Omnisports EXCEL). OUTCOMES: The primary outcome is fall-related injuries. Severity of injuries, falls, cost-effectiveness, user views and mechanical performance (shock absorbency and slip resistance) are also being assessed. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00817869; UKCRN ID: 5735. [ABSTRACT FROM AUTHOR]