Browsing by Author "Martins, Teresa"
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- Medication fall risk in old hospitalized patients: a retrospective studyPublication . Dias, Maria José Costa; Oliveira, Alexandre Santos; Martins, Teresa; Araújo, Fátima; Santos, Ana Sofia; Moreira, Cristina Nogueira; José, HelenaBackground: While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth. Objective: The objective of this study was to explore the association between medication and falls and the recurrent falls (n ≥ 2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital. Design: Retrospective and quantitative study from June 2008 to December 2010. Setting: The study was conducted in a private hospital for acute patients in Lisbon, Portugal. Participants: The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients. Methods: The current study was conducted through the “face to face consensus” technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score. Results: Patients who received drugs from the therapy group of “Central Nervous System”, are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6–60.63). Association was found between falls (OR 6.09, 95% CI 1.30–28.54) and its recurrence (OR 3.32, 95% CI 1.61–6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59–6.07). In 34% of the patients the medication fall risk score was 6 or higher. Conclusions: This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals.
- Quedas dos doentes internados em serviços hospitalares, associação com os grupos terapêuticosPublication . Costa-Dias, Maria; Oliveira, Alexandre; Moreira, Cristina; Santos, Ana; Martins, Teresa; Araújo, FátimaAs causas das quedas são multifatoriais e os fármacos têm um contributo significativo. O objetivo deste trabalho é explorar a associação entre os fármacos e as quedas e a sua recorrência (n≥2), no período de internamento, num hospital da grande Lisboa, entre junho de 2008 e dezembro de 2010. O seu desenho é retrospectivo, a partir de uma amostra de 214 episódios de notificação de incidente de queda de 190 doentes. Através da técnica de consenso face a face, emergiram os grupos terapêuticos a pesquisar. Na análise dos dados utilizou-se o t de student, ANOVA e Odds Ratio. Os doentes que efetuam fármacos associados ao risco de queda, têm 10 vezes mais risco de queda (OR=9,90; IC95%; 1,61-60,63), em especial quando pertencem ao grupo terapêutico do Sistema Nervoso Central. Foi identificada associação com as quedas e sua recorrência e estar medicado com haloperidol (OR=6,09; IC95%; 1,30-28,54) (OR=3,32; IC95%; 1,61-6,85). Este estudo permitiu identificar fatores que os enfermeiros devem ter em atenção na prescrição de intervenções, para prevenção das quedas e sua recorrência, aos doentes internados em hospitais de cuidados agudos.
- Study of the cut-off point of the Morse Fall Scale (MFS)Publication . Costa-Dias, Maria; Martins, Teresa; Araújo, FátimaTheoretical framework: The Morse Fall Scale (MFS) is a scale for assessing fall risk. It is designed for adults and widely used in Portugal. The scale should be calibrated for each particular setting so that fall prevention strategies are targeted to patients most at risk. Objective: To analyse the cut-off point of the scale that best distinguishes between people with and without fall risk in a hospital inpatient setting. Methodology: The receiver operator curve (ROC) was used to determine the optimal cut-off point. The predictive validity of the MFS was assessed through sensitivity and specificity, positive and negative predictive values, the ROC area under the curve (AUC) and also the Youden Index. Results: The cut-off point of 45 was identified as the optimal cut-off value, where 78% of the participants were identified as true positives and 22% as false negatives. It presented an OR of 3.8 (95%CI=2.17-6.51). Conclusion: The MFS is a good instrument for identifying patients with high fall risk in hospital settings, particularly in medical and surgical, long-term and palliative care inpatient wards.