A guideline for adults with an indwelling urinary catheter in different health care Settings - methodological procedures / Eine institutionsübergreifende Leitlinie für erwachsene Personen mit Blasenkatheter ­ methodisches Vorgehen

Background: People with an indwelling urinary catheter often suffer from complications and health care professionals are regularly confronted with questions about catheter management. Clinical guidelines are widely accepted to promote evidence-based practice. In the literature, the adaptation of a guideline is described as a valid alternative to the development of a new one. Aim: To translate a guideline for the care for adults with an indwelling urinary catheter in the acute and long term care setting as well as for home care. To adapt the guideline to the Swiss context. Method: In a systematic and pragmatic process, clinical questions were identified, guidelines were searched and evaluated regarding clinical relevance and quality. After each step, the next steps were defined. Results: An English guideline was translated, adapted to the local context and supplemented. The adapted guideline was reviewed by experts, adapted again and approved. After 34 months and an investment of a total of 145 man working days, a guideline for the care for people with an indwelling urinary catheter is available for both institutions. Conclusions: Translation and adaptation of a guideline was a valuable alternative to the development of a new one; nevertheless, the efforts necessary should not be underestimated. For such a project, sufficient professional and methodological resources should be made available to achieve efficient guideline work by a constant team.

Involvement of older people in the development of fall detection systems: a scoping review.

BACKGROUND: The involvement of users is recommended in the development of health related technologies, in order to address their needs and preferences and to improve the daily usage of these technologies. The objective of this literature review was to identify the nature and extent of research involving older people in the development of fall detection systems. METHODS: A scoping review according to the framework of Arksey and O'Malley was carried out. A key term search was employed in eight relevant databases. Included articles were summarized using a predetermined charting form and subsequently thematically analysed. RESULTS: A total of 53 articles was included. In 49 of the 53 articles, older people were involved in the design and/or testing stages, and in 4 of 53 articles, they were involved in the conceptual or market deployment stages. In 38 of the 53 articles, the main focus of the involvement of older people was technical aspects. In 15 of the 53 articles, the perspectives of the elderly related to the fall detection system under development were determined using focus groups, single interviews or questionnaires. CONCLUSIONS: Until presently, involvement of older people in the development of fall detection systems has focused mainly on technical aspects. Little attention has been given to the specific needs and views of older people in the context of fall detection system development and usage.

[nutritionDay- an annual cross-sectional audit of nutrition in healthcare]. / nutritionDay - eine Aktion gegen Mangelernährung.

nutritionDay is a worldwide project to determine prevalence of symptoms of malnutrition and reduced nutrient intake as well as risk factors and outcome. Individual units can benchmark their data against data from the reference database of the same specialty. Questionnaires are available in 32 languages. 151'666 patients from 4'877 units in 51 countries have participated between 2006 - 2012. In hospitals 8.1 % had a BMI < 18.5, 45.4 % indicated having lost weight and 49.9 % had not eaten normally last week. On nutritionDay 41.5 % ate the full meal at lunch or dinner and 14 % ate nothing. The odds ratio for death in hospital within 30 days was 2.76 [2.50, 3.05] if having lost weight, increased to a maximum of 6.17 [5.54, 6.88] with a history of decreased intake last week and 7.66 [6.72, 8.74] if no intake was found on nutritionDay despite being allowed to eat. All factors remained significant in multivariate analysis. The most frequent reason for not eating is loss of appetite. Only a maximum of one third of all patients that eat nothing receive support with enteral or parenteral nutrition. Disease-related undernutrition is very frequent in hospitals and is associated with poor outcome. nutritionDay is a measurement tool to determine the prevalence of undernutrition and to benchmark regularly nutrition risk factors and level of interventions against a large recent reference database.