Bedrails and Falls in Nursing Homes: A Systematic Review.

Bedrail use for fall prevention in elderly clients (>65 years) is controversial. Some healthcare providers believe bedrails prevent falls, while others think they are ineffective and dangerous. A systematic review was conducted to address: "For older adults living in nursing homes, does more or less bedrail use reduce the incidence of falls?" We searched HealthStar, MEDLINE, CINAHL, Academic Search complete ProQuest and Canadian Health Research Collection using "elder*," "bedrail*," "fall*," and "assisted-living*." After filtering for primary data, English records, older adult population, relationship between bedrails and falls, fourteen studies remained. Results suggest using alternative fall prevention measures, and bedrails are either beneficial, harmful, or do not influence falls. Bedrail reduction with fall prevention interventions led to no changes in fall frequency. Ambiguity persists regarding fall frequencies and bedrail use without using other fall prevention strategies. Educating health care providers on fall prevention is key to patient safety.

South Asians' cardiac medication adherence.

AIM: This paper is a report of a narrative review examining the current state of knowledge regarding adherence with cardiac medication among South Asian cardiac patients. BACKGROUND: South Asians experience higher rates of cardiovascular disease than any other ethnic group. South Asians may be less adherent with a cardiac medication regimen than Caucasians. The factors contributing to adherence are important to discover to assist South Asians to optimize their cardiac health. DATA SOURCES: CINAHL, Medline (Ovid), PsychINFO, EMB Reviews-(Cochrane), and EMBASE were accessed using the key words: 'South Asian', 'Asia', 'East India', 'India', 'Pakistan', 'Bangladesh', 'Sri Lanka', 'medication compliance', 'medication noncompliance' and 'medication adherence'. English language papers published from January 1980 to January 2013 were eligible for inclusion. REVIEW METHODS: Abstracts were reviewed for redundancy and eligibility by the primary author. Manuscripts were then retrieved and reviewed for eligibility and validity by the first and last authors. Content analysis strategies were used for the synthesis. RESULTS: Thirteen papers were in the final data set; most were conducted in India and Pakistan. Medication side-effects, cost, forgetfulness and higher frequency of dosing contributed to non-adherence. South Asian immigrants also faced language barriers, which contributed to non-adherence. Knowledge regarding the medications prescribed was a factor that increased adherence. CONCLUSION: South Asians' non-adherence to cardiac medications is multifaceted. How South Asians who newly immigrate to Western countries make decisions regarding their cardiac medication adherence ought to be explored in greater detail.