The promotion of physical activity and prevention of falls among older adults admitted to hospitals and long term care facilities are influenced by the perspectives of nurses and patients, and factors such as the institutions’ policy on patient handling, the environment and patient characteristics. To ensure that physical activity and fall-prevention become priorities in care, nurses need more knowledge on the benefits from physical activity and the adverse outcomes related to immobilization and falls, as well as knowledge on factors affecting the care. Further nurses must assess the factors affecting the care, and implement effective measures to promote physical activity and prevent falls. Figure 2 provides an overview of how nurses can promote physical activity among older adults admitted to hospitals and long term care facilities.
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Figure 2 An overview of how physical activity and fall-prevention can become an integral part of care in hospitals and long term care facilities
Education of nurses
- Risks associated with immobilization - Benefits of physical activity
- What characterize patients with a high risk of falling and physical decline
- Effective measures to increase physical activity and prevent falls
Assessment Policy - Policy regarding patient handling
- Ward routines - Staffing
Environment - Factors that restricts the patients’
possibility to perform physical activity such as space and equipment
Patients - History: Previous lifestyle, falls, physical decline prior to admission - Perception of physical activity - Level of frailty
- Cognitive function
- Physical function, balance, gait - Symptoms
- Pain
- Fear of falling
Interventions - Involve the patients in goal-setting and decision-making - Customize the interventions to individuals’ needs - “Function focused care”
Information:
- Written and oral
information by the bed with instructions on how to perform physical activity, how to mobilize safely and how to use assistive devices
Measures:
- Move patients at high risk of falling closer to the nursing station
- Schedule toileting times - Use electronic monitoring
devices
- Provide assistance with mobility
- Offer a variety of activities - Monitor the effects of
medications
- Symptom – management
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Litteraturliste
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nurses and care assistants to patients’ mobility rehabilitation.
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Scuffham, P., Chaplin, S., & Legood, R. (2003). Incidence and costs of unintentional falls in older people in the United Kingdom. 740-744. ISSN 1470-2738.
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Vedlegg
Authors guidelines – Journal of clinical nursing
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