RESUMO
The world population is dramatically ageing, resulting in an increase of the prevalence of older dependent adults living in nursing homes (NHs). Because of insufficient resources in NHs, and nurses' lack of time and knowledge, adverse events, most of them being preventable, are often reported. Clinical decision support systems (CDSSs) have proven to improve the quality of care in various healthcare settings such as hospitals and primary care centers. However, the use of CDSSs in NHs is still limited and little is known about their influence on nursing practices and NH residents' clinical outcomes. We conducted a scoping review of the literature to evaluate CDSS use in NHs. Out of 1,231 retrieved papers, 15 studies were retrieved which assess 10 CDSSs applied to pressure ulcers and malnutrition prevention, drug prescription, and disease management. This review showed CDSSs could be effective in NHs for improving routine clinical practice and patient outcomes, but research is still needed to implement effective CDSSs in NHs.
Assuntos
Sistemas de Apoio a Decisões Clínicas , Prescrições de Medicamentos , Humanos , Casas de Saúde , Úlcera por Pressão , Atenção Primária à SaúdeRESUMO
Health simulation has become widely used in training institutes and health care institutions in recent years. In geriatric/gerontology training, a device for simulating age-related limitations is used allowing the participant to experience the functional and sensory limitations experienced by older people.
Assuntos
Envelhecimento/fisiologia , Geriatria/educação , Treinamento por Simulação , Idoso , Difusão de Inovações , HumanosRESUMO
Hypotension and especially very low diastolic blood pressure could be an at-risk situation in very old and frail patients and in those with coronary heart disease. Chronic hypotension in people with heart failure is an indicator of poor prognosis and hinders the management of therapy. Orthostatic hypotension is a decrease in blood pressure>20mmHg for systolic and/or>10mmHg for diastolic within 3minutes after transition from supine to upright. Orthostatic hypotension may be symptomatic or not. The search for orthostatic hypotension is part of the clinical examination of elderly patients with hypertension, falling, diabetes and or polymedication. First intention treatment aims to correct modifiable modifying factors and to limit the circulatory consequences of orthostatism by elastic venous compression.