NURS 6630 Assessing and Treating Clients With Dementia Patients
NURS 6630 Assessing and Treating Clients With Dementia Patients
Decision Point Two
Selected Decision
After a review of the performance of Exelon four weeks after its administration, the nurse practitioner was presented with certain three options. These were: Increase Exelon to 4.5 mg orally BID, increase Exelon to 6 mg orally BID, Maintain current dose of Exelon, and Add Namenda (memantine) 5 mg orally per day. From the three options, the nurse practitioner chose to increase Exelon to 4.5 mg orally BID.
Reason for Selection
When the client was given the previous dose of Exelon, he demonstrated improvement in his Alzheimer’s symptomatology. Specifically, while he has not wholly accepted to attend church activities, he has begun to show a slight interest. The manifestation of the improvement is evident that the drug has some level of effectiveness at this level. Thus, in addition to the fact that the clients has shown remarkable tolerability to the dosage, the logical thing would be to increase it to 4.5 mg. Pharmacologically, the 4.5 mg would be the maintenance dose of the drug, in order to sustain its effectiveness (Stahl, 2013). Whereas the dosage could be increased to 6 mg, it is vital for the increments to be conducted cautiously as tolerability is monitored. Moreover, prescribing Namenda (In Nageshwaran, In Ledingham, In Wilson, & In Dickenson, 2017) at the present point is not logical since the Exelon has not yet reached its maximum therapeutic level. Thus, Yoon et al. (2017) advises that it is paramount for the maximum potential option to be followed before augmentation can be considered. Also, it would be imprudent to maintain the dosage at its initial level since the drug will not produce maximum benefits. These reasons therefore support the decision to increase Exelon’s dosage to 4.5 mg.
Expected Results
Upon increasing the drug’s dosage, the symptoms are expected to improve even further. Specifically, the restricted confabulation is expected to reduce even further due to the drug’s dosage. In addition to confabulation, the patient’s resistance towards church activities is expected to wane during the intervening period after dosage increase and the next assessment.
Differences between Expected Results and Actual Results
When the client came back to the clinic after four weeks had elapsed since the decision to increase Exelon’s dosage was made, he shows remarkable improvement in certain symptoms of Alzheimer’s. For instance, his son states that Mr. Akid had started to attend church activities more frequently. As expected, some of the symptoms such as amusement towards his erstwhile favorite activities still existed. Chen et al. (2017) argues that the symptomatology of Alzheimer’s ca only be improved and not eliminated. In fact, the drug Exelon can only improve other functions but cognition hence the reason for the persistence of the amusement symptom. Thus, there was no difference between expected results and actual results after the assessment.
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. They may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric mental health nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for clients across the lifespan. For this Assignment, you consider how you might assess and treat clients presenting with ADHD.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: Review all materials from the Discussion.
Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.
Note: Retrieved from Library databases.
Required Media
Laureate Education (2016d). Case study: A young Caucasian girl with ADHD [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
This case study will serve as the foundation for this week’s Assignment.
The Assignment
Examine Case Study: A Young Caucasian Girl With ADHD You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
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What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 10 assignment
Assignment: Assessing and Treating Clients With Dementia
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.
Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp
Required Readings
Note: All Stahl resources can be accessed through the Library using this link. This link will take you to a log-in page for the Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 13, “Dementia and Its Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
donepezil
galantamine
memantine
rivastigmine
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Library databases.
Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf
Required Media
Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.
The Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Stakeholders refer to individuals or organizations likely to be affected by the change, decision, or project outcome. They have an interest or are affected by the project or an initiative. Stakeholder identification is vital in project management, as it facilitates efficiency and enhanced realization of the project objectives (Slabá et al., 2019).
The identification of stakeholders for the project was to utilize interventions that included brainstorming and interviewing influential individuals in the organization. There was brainstorming with team members as well as experts in nursing.
The brainstorming aimed to identify individuals who were most likely to be affected or benefit from the project (Gregory et al., 2020).
The brainstorming sessions aimed to answer questions related to individuals, directly and indirectly, involved and affected by the project, losers and gainers from the project, individuals to facilitate the successful implementation of the project, and individuals that may cause the project failure. (Gregory et al., 2020)
The second strategy utilized to identify the stakeholders was interviewing influential people. They included Nurse Leaders, Managers, and Team Leaders. The interview provided critical information about individuals who were likely to benefit and be disadvantaged with the project implementation.
The interview also provided insights into the success strategies needed for the project’s success.
The next step after stakeholder identification was stakeholder prioritization. Stakeholder prioritization was done based on the power and interest towards the project. The power-interest grid was adopted where stakeholders with high power and high interest in the selection process (Slabá et al., 2019).
Stakeholders with high power, low interest, and low power were not selected, as they could drag the successful realization of the desired project objectives.
Stakeholder identification and prioritization led to selecting three individuals, including the Nurse Manager, Nurse Leader, and Unit Preceptor. The individuals to have high interest and high power, which meant that they could contribute significantly to the project’s success. They also had extensive experience in project implementation and initiating change in healthcare settings.
The Nurse Manager has extensive experience and skills in managing change projects in the organization. For the last five years, she has been a Nurse Manager and has received awards for her ability to drive excellence in the organization.
She also has an adept understanding of the systems and processes needed for the successful implementation of the project.
The Nurse Leader is highly influential in the organization. She knows how to lead and motivate the employees to embrace the desired actions and behaviors for organizational success.
The Preceptor has extensive experience in leading interprofessional teams in implementing best practices in healthcare. As a result, he is well-positioned to lead the implementation of the project.
Roles of the Consulted Individuals
The identified stakeholders will play critical roles in supporting the proposed healthcare improvement project.
For example, the Nurse Manager will coordinate the entire project activities. She will utilize her experience in project management to ensure the realization of the project deliverables as planned in the proposal.
The Nurse Leader will use her influential power to motivate the staff to adopt the proposed change. The leader will also guide the implementation the best practices needed for the project’s success.
The Preceptor will lead the inter-professional teams in implementing the project (Boaz et al., 2018). He will also provide assessment data on the strategies needed to ensure enhanced outcomes in the healthcare improvement project.
Needs Assessment Using Affinity Analysis
The need for the healthcare improvement project was determined using affinity analysis. Affinity analysis refers to a method of determining the co-occurrence of relationships in ideas and activities undertaken by groups or individuals.
Affinity analysis represents the output from brainstorming ideas by groups of individuals. The process generates, organizes, and consolidates information related to the interest issue. Some processes were utilized in the affinity analysis approach to determine the need for the healthcare improvement project.
One of the processes was brainstorming ideas of the stakeholders on issues affecting dementia patients in the setting. The stakeholders wrote their ideas on stick notes to analyze their perceived critical issues affecting dementia patients in the institution (Stern, 2020). The stakeholders posted their ideas on the chart pack randomly for team analysis.
The second step in the process was examining the ideas by the stakeholders to identify interrelated ideas. The stakeholders examined and grouped ideas closely related to preventing falls among dementia patients in the setting. The grouping process also led to identifying lone ideas that did not share any similarities.
The third step entailed the discussion of the grouped ideas with the stakeholders. The discussion focused on defining categories of ideas and creating summaries for each group of ideas (Mizuno & Bodek, 2020). The stakeholders also reached a consensus on eliminating any controversial ideas and making changes or improvements when deemed necessary.
Sub-themes represent the grouped ideas to capture the meaning of the entire group. The purpose of developing the sub-themes was to identify best practice interventions adopted to address patients with dementia in the setting.
The last step was combining the sub-themes into main themes. Combining the sub-themes ensured that the stakeholders agreed on the best approach to guide the healthcare improvement project (Stern, 2020).
The stakeholders reached a consensus by discussing the developed ideas, subthemes, and themes. They discussed the relevance, similarities, and differences that brainstormed ideas, sub-themes and themes had.
They also discussed the overall implications of the adopted themes on understanding the clinical issue. They agreed on the best practice intervention relevant to the healthcare improvement project.
Also Read: NURS 6630 Discussion Reflect On Concepts Of Foundational Neuroscience
TASK 2: INTRODUCTION FOR HEALTH IMPROVEMENT PROJECT.
- INTRODUCTION
- Problem Background
Promoting safety, quality, and efficiency in patient care is essential for their health and wellbeing. However, patient falls adversely affect the safety and quality of care that patients receive. Patients of a specific category, such as those with dementia, have an increased risk of falls.
Patients who have dementia have an increased risk of falls due to factors such as impaired judgment, visual-spatial perception, gait, and the ability to identify and avoid hazards that relate to falls (Peek et al., 2018).
The risk for falls in patients with dementia in the US is twice higher than those without the disorder (Fernando et al., 2017). Dementia is associated with adverse effects on the patients’ health and their careers. As a result, falls in these patients predispose them to worse health outcomes and poorer quality of life (Wheatley et al., 2019).
Falls in patients with dementia cause adverse effects, including injuries, increased care costs, and mortality (Peek et al., 2018). Nurses and other healthcare providers have a critical role in preventing falls in patients with dementia.
They utilize evidence-based interventions in inpatient care to optimize the care outcomes in patients with dementia (Oki et al., 2021). In addition, they explore inter-professional interventions that can be adopted to reduce and prevent falls in patients with dementia (Rajagopalan et al., 2017).
Health information technologies such as wearable sensors and motion detectors effectively reduce the risk and prevent falls in patients with dementia. The technologies enhance the ability of healthcare providers to respond promptly to patients’ vulnerability to falls in their settings, thereby promoting the patients’ health (Baig et al., 2019).
Despite the efficacy of the systems, the practice site has not implemented its use, leading to a high rate of falls among patients with dementia. Therefore, the project’s focus is on using health information technologies such as wearable sensors to predict, prevent and reduce the rates of falls among patients with dementia.
The project is significant as it enhances the safety and quality of care. The reduction in the risk and prevention of falls promote safety and quality in care by preventing the predisposition of patients with dementia to outcomes such as injuries, prolonged hospital stays, and mortality (Wheatley et al., 2019).
The project also promotes cost-efficiency in care. Falls increase the costs incurred by patients due to prolonged hospital stays, and complex care needs to manage the effects of falls. The reduction in the risks and rates of falls in patients with dementia promotes cost-efficiency inpatient care (Fernando et al., 2017).
The project also informs evidence-based practice in nursing. It guides the introduction of evidence-based interventions that can be adopted to prevent falls in dementia patients and acute care settings.
Through the project, nurses know about efficient and effective ways of incorporating technology into dementia care to promote safety and quality in their settings (Peek et al., 2018).
- Description of the Problem
Dementia is one of the global health problems with adverse effects on the affected populations. Dementia is a term that encompasses a range of conditions associated with alteration in multiple high functions such as cognition, memory, communication, behavior, and the ability to perform the activities of daily living.
Patients with dementia are highly predisposed to falls compared to those without it. The risk and rate of falls annually are almost twice in patients with dementia compared to those without (Peek et al., 2018).
People with dementia have a history of falls five times and an increased risk of falls than those without any history of falls. Falls have adverse health effects on patients. Accordingly, it predisposes patients to fall-related injuries that include hip fractures.
It also increases mortality risk due to its complications (Fernando et al., 2017). Falls also predispose patients with dementia to health problems that include long-term disability, premature institutionalization, functional dependence, and traumatic brain injury.
Patients with a history of falls also develop a fear of falling, leading to anxiety and a decline in the quality of their lives (Stark et al., 2021).
Patients with dementia are increasingly predisposed to falls due to risk factors such as cognitive impairment and altered gait, balance, vision, and functional health status (Oki et al., 2021).
The medications that patients with dementia use also predispose them to falls due to their side effects, such as hypotension, confusion, and increased irritability (Wheatley et al., 2019).
Falls are associated with adverse economic effects to patients with dementia, healthcare institutions, and the state. For example, statistics estimates from the US show that about $30 billion is used annually for treating falls among elderly adults (Stark et al., 2021).
The costs incurred in the state for managing fatal falls in the US are estimated to be US $637.1 million and the US $31.3 billion for non-fatal falls. Due to the increased risk of falls in patients with dementia, its related hospitalizations to be 26% of all the hospitalizations in the US (Bayen et al., 2017).
The costs of treating dementia alone are significantly high for patients and their families. For example, Jutkowitz et al. (2017) found in their study that the cost of care for a person with dementia is $321,780 from the time of diagnosis until its optimum management or death due to its associated complications.
Families and patients incur 70% of the total cost burden from the above amount, while Medicaid and Medicare account for 14% and 15% of the costs, respectively.
The costs incurred by a family with a patient with dementia in healthcare are 86% higher than those without a dementia case (Jutkowitz et al., 2017).
Considering the above economic burden of dementia alone, a patient fall worsens the economic status of the patients and their families significantly, hence, the need for responsive interventions to address the problem.
Early detection and prevention of falls among patients with dementia are critical to promoting their health and wellbeing.
Early detection and prevention have the potential of reducing the morbidity as well as mortality associated with falls. Most of the elderly fallers (50-75%) experience recurrent falls in their lives irrespective of their disease states, making it imperative to take preventive measures to reduce fall-related injuries and fall risks at large (Bayen et al., 2017).
The implementation of rapid fall detection and prevention systems limits the risk of ling-lie, a predictor of worse health outcomes, reduced walking capacity, and prolonged hospital stay (Rajagopalan et al., 2017).
Rapid detection and prevention of falls also enhance the accuracy of care directed to injuries related to patient falls.
It also lowers the short-term indirect effects of falls such as hypothermia, phlebitis, and pressure sores alongside long-term fall-related effects such as fear of subsequent falls, loss of autonomy, and social isolation (Baig et al., 2019; Bayen et al., 2017).
Consequently, healthcare providers and institutions should embrace responsive interventions that promote early detection and prevention of falls among patients with dementia to enhance their health and wellbeing.
- Purpose Statement
This healthcare improvement project aims to examine the effectiveness of healthcare technologies such as wearable devices in reducing and preventing falls among patients with dementia.
Through its implementation, the cost, safety, and quality of care given to patients with dementia will improve significantly.
- (a) Project Management Lifecycle
Project management lifecycle is a model that organizations use to guide the implementation of their projects. The lifecycle comprises steps for optimum outcomes to be achieved in project implementation.
The steps include initiation, planning, execution, and closure. Initiation is the first step in the cycle where the project stakeholders identify an organizational need, problem, or opportunity for enhanced performance and productivity.
The stakeholders also develop the objectives of the project and its feasibility. They also develop deliverables that will guide the project implementation process.
The activity in this phase of the cycle in the proposed project will be the development of project objectives and deliverables (Clegg et al., 2020). The objectives and deliverables will guide the implementation process of the project.
The second step to be noted in the project management lifecycle is planning. Planning is when the stakeholders break down the more significant project deliverables into smaller, achievable tasks.
The stakeholders also develop an inter-professional team that will be held responsible for overseeing the implementation of the project.
They also develop timelines for completing the project tasks. At this phase, the project stakeholders must develop smaller goals that will underpin the project’s main objective, vision, and mission.
During the implementation of the healthcare improvement project, the activity in this step is creating a project plan (Clegg et al., 2020). A project plan comprising project timelines, phases, tasks, resources, and budget will guide the implementation of the process.
The third step in the project management lifecycle is execution. Execution is when the developed strategies in the planning phase are in practice. The stakeholders turn the project plan into action.
The project management leaders ensure that the project activities are on track in this phase. They organize the team members, assign roles and responsibilities, manage the project timelines, and ensure the implementation according to the developed plan.
One of the activities that will occur in this phase during the implementation of the healthcare improvement project will be creating tasks for teams and organizing workflows. The project leaders will assign tasks to the appropriate team members and ensure efficiency in the project’s implementation (Clegg et al., 2020).
The leaders will also coordinate project activities to ensure execution aligns with the developed plan.
The last step in the project management lifecycle is closure. The closure is when the project stakeholders provide the end deliverables of the project, release resources of the project and evaluate the success of the project in achieving its outcomes.
The closure provides an opportunity to reflect on the project successes, weaknesses, and opportunities that should achieve optimum outcomes in similar projects in the future.
One of the activities undertaken in this phase during the closure of the healthcare improvement project will be evaluating the project’s effectiveness. Process and outcome measures will determine whether the desired objectives of the project were achieved or not (Clegg et al., 2020).
In addition, feedback to the team members involved in the project to inform their practice.
4 (b). Project Guidance Initiation to Closure
The project management lifecycle will guide the project from its initiation to closure. It will provide the stakeholders with insights into the project objectives and deliverables.
It will also guide the development of an inter-professional team to implement the project.
The lifecycle will also guide the development of project strategies that would achieve the expected outcomes.
The project management lifecycle will also provide the desired structure for delivering the project.
It will provide a framework for enhancing project activities such as scheduling, communication, and collaboration.
The cycle will also guide the progressive evaluation of the project at different stages of its implementation.
The evaluation will inform the implementation of interventions that improve the project outcomes.
Lastly, the model will guide progress throughout the project implementation, evaluation, and termination processes (Institute, 2019). The tracking will eliminate potential issues such as task duplication and infective use of resources for the desired result to be achieved in the organization.
- Review of Relevant Scholarly Sources.
- Scholarly Review Purpose
A scholarly review of sources on the selected healthcare improvement project with some aims was to determine the credibility and reliability of evidence supporting the use of the intervention in addressing the clinical issue.
The sources of evidence should have valid, reliable, and credible evidence to inform the clinical practice in nursing.
The other purpose of the scholarly source review was to identify gaps in practice. Identifying gaps in practice informed the need for the healthcare improvement project. It also strengthened its relevance to the organization and its ability to address its needs.
The third aim of the scholarly review in the healthcare improvement project was to learn about the project’s practical ways. Accordingly, the sources of scholarly evidence inform the strategies utilized in the translation of evidence into practice (Dingwall & Staniland, 2020). Therefore, a scholarly review of sources of evidence must inform the need and relevance of healthcare improvement projects
- Table of Scholarly Sources
| First Author and (Publication Year) | Scholarly Source Title | Type of Scholarly Source | Relevance |
| 1. Behera et al. (2021) | State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review | Peer-reviewed journal | This article is relevant to the proposed project, as it explores the benefits of using health information technologies in promoting safe inpatient care. It explores the benefits of technology use in detecting and preventing patient falls. It also provides insights into the factors for the effective use of health information systems of patients with dementia. |
| 2. Bezold et al. (2021) | Sensor-based fall risk assessment in older and aged adults with or without cognitive impairment: A systematic review | Peer-reviewed journal | This article is relevant to the proposed project as it shows the efficiency associated with technologies used in detecting, preventing, and reducing falls among elderly patients. The article shows that sensor technologies have a high level of accuracy in fall detection. The results also show that the technology reduces the workload for healthcare providers. It also shows that the use of sensor technologies for fall prevention is a feasible project in acute care settings, including those involved in the care of patients with dementia.
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| 3. Boutella et al. (2019) | Covariance matrix-based fall detection from multiple wearable sensors | Peer-reviewed journal | This article is relevant to the proposed project, as it shows that health information technologies are effective in fall detection and prevention. The article shows that automatic fall detection systems are easy to use and provide highly accurate data that can aid the promotion of safety in healthcare by preventing falls.
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| 4. Gettel et al. (2021) | Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review | Peer-reviewed journal | This article relates to the healthcare improvement project by showing the effectiveness of healthcare technologies in fall prevention in elderly patients with dementia. The article shows that the technologies improve function, cognitive status, psychosocial status, caregiver burden, and home safety.
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| 5 Potter et al. (2017) | Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care. | Peer-reviewed journal | This article relates to the project, as it explored the effectiveness of sensor technologies in preventing falls in acute care settings. The article shows that sensor technologies have enhanced efficiency over fall alert systems. It also shows that healthcare technologies in fall prevention are viable in healthcare settings. |
| 6 Subermaniam et al. (2017) | The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients. | Peer-reviewed journal | The article relates to the project by examining healthcare technologies in fall prevention among elderly patients. The article shows that technologies have enhanced effectiveness in accurately detecting bed absence episodes. The technologies also reduced workload scores. The rate of acceptability of the technologies is high among nurses.
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| 7 Sun & Sosnoff (2018) | Novel sensing technology in fall risk assessment in older adults: A systematic review | Peer-reviewed journal | The article relates to the project by showing that healthcare technologies such as sensors effectively reduce the risk of falls among older adults. The technologies provide accurate, inexpensive, and easy methods to prevent falls.
|
- Scholarly Source Synthesis
All the selected articles for the synthesis recognize that falls in elderly patients and those with dementia are critical health concerns with adverse health effects.
The sources further identify that falls and related injuries are preventable and predictable. Falls can be detected and prevented using interventions that aim at modifiable risk factors that predispose patients to falls, such as mobility, balance, and muscle strength (Sun & Sosnoff, 2018).
Effective adoption of fall prevention programs promotes cost efficiency in healthcare and maximizes the quality of life of patients with dementia.
Most of the selected articles agree that healthcare technologies such as sensors, pressure sensors, ambient motion sensors, and low-cost depth cameras and videos are effective in fall detection and prevention.
For example, Sun and Sosnoff (2018) assert that technologies provide accurate data to determine fall’ risk assessment and alert nurses about the need for responsive actions to prevent falls.
Despite evidence about the effectiveness of technologies in fall prevention, minimal interventions have to examine their use in the acute care of elderly patients.
In addition, limited evidence exists on the use of the technologies in undertaking fall risk assessment (Sun & Sosnoff, 2018). Subermaniam et al. (2017) provide similar assertions in their study that wireless modular bed absence sensor devices accurately detected bed absence episodes in geriatric inpatients and alerted nurses accordingly.
The authors found that the technology had 100% sensitivity and a 68% positive predictive value.
The technology further reduced the workload score by the end of the intervention, with 83% of the nurses considering it an effective tool for fall prevention.
However, the difference between the study by Subermaniam et al. (2017) and Sun & Sosnoff (2018) lies in the methodologies where the former used a two-part, uncontrolled study design while the latter was a systematic review.
The study by Potter et al. (2017) evaluated the effectiveness of sensory technology in detecting a risk of falls and preventing falls in acute care.
The study showed themes that included reducing fall rates and total patient-bed days.
The study also revealed the theme of enhanced efficacy of the sensory systems over the standard fall alert systems in fall detection and prevention in acute care settings.
As a result, the researchers recommended adopting fall prevention systems, as they are viable in healthcare organizations.
The systematic review by Bezold et al. (2021) also revealed a similar theme. The use of healthcare technologies in fall detection and prevention was to have a high level of accuracy and feasibility in elderly adults, irrespective of their cognitive status.
Unlike Potter et al. (2017), Bezold et al. (2021) identified factors such as the location of the sensors, type, and attachment to affect the accuracy of detection and alerts by the adopted healthcare technologies.
Gettel et al. (2021) investigated the effectiveness of ambient-assisted living, fall detection, and dementia care technologies in promoting safety in dementia care.
The study revealed themes that included improved function, cognitive and psychosocial status, caregiver burden, and home safety using the technologies.
The others, however, noted the need to consider barriers to the use of technologies in fall detection and prevention, such as privacy concerns, willingness to accept assistance, and suboptimal user experience (Gettel et al., 2021).