Use of Sensors for Fall Prediction in Older Persons: A Scoping Review

The application of technological advances and clear articulation of how they improve patient outcomes are not always well described in the literature. Our research team investigated the numerous ways to measure conditions and behaviors that precede patient events and could signal an important change in health through a scoping review. We searched for evidence of technology use in fall prediction in the population of older adults in any setting. The research question was described in the population-concept-context format: "What types of sensors are being used in the prediction of falls in older persons?" The purpose was to examine the numerous ways to obtain continuous measurement of conditions and behaviors that precede falls. This area of interest may be termed emerging knowledge . Implications for research include increased attention to human-centered design, need for robust research trials that clearly articulate study design and outcomes, larger sample sizes and randomization of subjects, consistent oversight of institutional review board processes, and elucidation of the human costs and benefits to health and science.

IMPACT OF SOCIAL ISOLATION ON OLDER ADULTS IN NURSING HOMES DURING THE PANDEMIC LOCKDOWN: INFORMING POLICY

Purpose

Describe outcomes of an equity-centered community design (ECCD) project examining the impact of COVID-19 restrictions and social isolation on nursing home (NH) owners, administrators, community leaders, clergy, and urban homeless shelter staff. •

Methods

3-phase, ECCD project. Key informants (KI) were recruited through snowball sampling if experienced in caring for older adults (OA) in NH, in the community, or were engaged in spiritual care of OA.•

Results

Perceptions of fear, anger, frustration, sadness, and concern. Categories of Lost Communication and Socialization Strategies, Lost Freedom, Residents’ Dying Alone and Inability to Pause to Grieve, Helplessness and Hopelessness, Inability to Take Time to Grieve, and Behavior Changes. KI offered New Ways of Communicating, and interventions and solutions were generated in Phase III.• Implications. Understanding of Stakeholder experiences and perceptions is important to achieving inclusive, equity-centered solutions. Future policy decisions must consider what matters most to those most directly impacted by those decisions.

Recruiting Resident Participants from Nursing Homes During the COVID Pandemic: Challenges and Solutions

Recruiting nursing home residents as participants in research is challenging. In early 2021, Covid-19 cases rose rapidly in nursing homes, prompting the rapid deployment of infectious disease protocols and ultimately, facility lockdowns to control the spread of the virus. By September, 2020, many research projects were delayed or cancelled, and future research was jeopardized. During this period, as well as prior to and after the administration of the COVID vaccine, we enrolled residents in a complex protocol involving administration of two Shingles vaccines (0- and 90 days) and three separate blood samples. Here, we present the strategies we used to recruit 216 residents, from 23 homes, over a 9-month period. We faced many challenges. Our research staff faced weekly COVID-19 antigen tests prior to entering the facility, adhering to strict protocols on travel, as well as packaging of materials that entered and left the facility. N95 masks and face shields further made it difficult to communicate with residents. For homes, COVID protocols required residents to be transported to specified areas to meet with research staff. Daily monitoring of COVID and Shingrix vaccine symptoms became part of daily care. To minimize resident harm and interruption of workflow in nursing homes, we utilized principles of stakeholder engagement, healthcare leadership, infectious disease/immunology, and staff (research and nursing homes) empowerment. In the face of crisis, like the COVID-19 pandemic, we have gained the trust and commitment of these facilities; thus, establishing a sustainable partnership that is prepared for what comes next.

Knowledge and experiences with augmentative and alternative communication by paediatric nurses: a pilot study

PURPOSE

The current mixed methods research study was designed to describe the experience and opinions of paediatric acute care nurses at a single paediatric medical centre regarding augmentative and alternative communication (AAC). This research serves as the beginning of a line of research to determine needs that can be met through later education and training on AAC with paediatric acute care nurses.

METHODS

Mixed methods were used to gather survey and interview data from nurses at a single paediatric hospital to investigate their knowledge of AAC, perceived relevance of AAC for their patient populations, and preferences for training programmes.

RESULTS

Quantitative survey and qualitative interview data indicated a need for AAC education for these paediatric nurses. Nurses demonstrated limited knowledge and experience with AAC but communicated both a desire and perceived need to know more to effectively care for their patients.

CONCLUSION

Nurses reported limited AAC knowledge but expressed a desire for support to use AAC with their patients. AAC education and cross-sector collaboration with healthcare workers such as speech-language pathologists (SLPs) and acute care paediatric nurses are indicated to support effective communication when interacting with patients with complex communication needs (CCN).Implications for rehabilitationImproved background knowledge to develop and implement future nurse education on AAC.Foundation for cross-sector collaboration (e.g., nurses and SLPs) on AAC implementation in paediatric acute care settings.