Showing posts with label fall disability. Show all posts
Showing posts with label fall disability. Show all posts

Tuesday, March 29, 2011

Arch Intern Med -- Abstract: Patient Education to Prevent Falls Among Older Hospital Inpatients: A Randomized Controlled Trial, March 28, 2011, Haines et al. 171 (6): 516

Arch Intern Med. 2011;171(6):516-524. doi:10.1001/archinternmed.2010.444

Background  Falls are a common adverse event during hospitalization of older adults, and few interventions have been shown to prevent them.

Methods  This study was a 3-group randomized trial to evaluate the efficacy of 2 forms of multimedia patient education compared with usual care for the prevention of in-hospital falls. Older hospital patients (n = 1206) admitted to a mixture of acute (orthopedic, respiratory, and medical) and subacute (geriatric and neurorehabilitation) hospital wards at 2 Australian hospitals were recruited between January 2008 and April 2009. The interventions were a multimedia patient education program based on the health-belief model combined with trained health professional follow-up (complete program), multi-media patient education materials alone (materials only), and usual care (control). Falls data were collected by blinded research assistants by reviewing hospital incident reports, hand searching medical records, and conducting weekly patient interviews.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Wednesday, March 2, 2011

FRAX, Fracture Probability Tool

Welcome to FRAX®

The FRAX® tool has been developed by WHO to evaluate fracture risk of patients. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck.

The FRAX® models have been developed from studying population-based cohorts from Europe, North America, Asia and Australia. In their most sophisticated form, the FRAX® tool is computer-driven and is available on this site. Several simplified paper versions, based on the number of risk factors are also available, and can be downloaded for office use.

The FRAX® algorithms give the 10-year probability of fracture. The output is a 10-year probability of hip fracture and the 10-year probability of a major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture).

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Monday, November 15, 2010

JAMA -- Abstract: Fall Prevention in Acute Care Hospitals: A Randomized Trial, November 3, 2010, Dykes et al. 304 (17): 1912

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Fall Prevention in Acute Care Hospitals

A Randomized Trial

Patricia C. Dykes, RN, DNSc; Diane L. Carroll, RN, PhD, BC; Ann Hurley, RN, DNSc; Stuart Lipsitz, ScD; Angela Benoit, BComm; Frank Chang, MSE; Seth Meltzer; Ruslana Tsurikova, MSc, MA; Lyubov Zuyov, MA; Blackford Middleton, MD, MPH, MSc

JAMA. 2010;304(17):1912-1918. doi:10.1001/jama.2010.1567

Context  Falls cause injury and death for persons of all ages, but risk of falls increases markedly with age. Hospitalization further increases risk, yet no evidence exists to support short-stay hospital-based fall prevention strategies to reduce patient falls.

Objective  To investigate whether a fall prevention tool kit (FPTK) using health information technology (HIT) decreases patient falls in hospitals.

Design, Setting, and Patients  Cluster randomized study conducted January 1, 2009, through June 30, 2009, comparing patient fall rates in 4 urban US hospitals in units that received usual care (4 units and 5104 patients) or the intervention (4 units and 5160 patients).

Intervention  The FPTK integrated existing communication and workflow patterns into the HIT application. Based on a valid fall risk assessment scale completed by a nurse, the FPTK software tailored fall prevention interventions to address patients' specific determinants of fall risk. The FPTK produced bed posters composed of brief text with an accompanying icon, patient education handouts, and plans of care, all communicating patient-specific alerts to key stakeholders.

Main Outcome Measures  The primary outcome was patient falls per 1000 patient-days adjusted for site and patient care unit. A secondary outcome was fall-related injuries.

Results  During the 6-month intervention period, the number of patients with falls differed between control (n = 87) and intervention (n = 67) units (P=.02). Site-adjusted fall rates were significantly higher in control units (4.18 [95% confidence interval {CI}, 3.45-5.06] per 1000 patient-days) than in intervention units (3.15 [95% CI, 2.54-3.90] per 1000 patient-days; P = .04). The FPTK was found to be particularly effective with patients aged 65 years or older (adjusted rate difference, 2.08 [95% CI, 0.61-3.56] per 1000 patient-days; P = .003). No significant effect was noted in fall-related injuries.

Conclusion  The use of a fall prevention tool kit in hospital units compared with usual care significantly reduced rate of falls.

Trial Registration  clinicaltrials.gov Identifier: NCT00675935


Author Affiliations: Partners HealthCare System (Drs Dykes and Middleton, Ms Benoit, and Messrs Chang and Meltzer), Brigham and Women's Hospital (Drs Dykes, Hurley, Lipsitz, and Middleton, and Ms Tsurikova), Harvard Medical School (Drs Dykes, Lipsitz, and Middleton), and Massachusetts General Hospital (Dr Carroll and Ms Zuyov), Boston.

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Themes of Aging: Preserving Function, Improving Care
Winker
JAMA 2010;304:1954-1955.
FULL TEXT  


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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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Wednesday, November 10, 2010

Independent Medical Examinations, Examiners, IMEs, Legal Nurse Consultant Resources, Medical, Legal, Malpractice - Law Consulting

New!

Donna M. Post, RN, BSN, MBA / HCM, CLNC, LNCP-C , Mid-Valley Legal Nurse Consulting, Inc., California Nurse Entrepreneurs, Legal Nurse Consultants:"Mid-Valley Legal Nurse Consulting has over 24 years of experience clinically and administratively, in cardiac, adult and pediatric critical care, and dialysis. Our experience extends to both the inpatient and outpatient settings. MVLNC provides effective identification of practice standards, regulatory standards, adherence and/or deviations to these standards. Our background provides our clients the added benefit of understanding healthcare infrastructure, budgets, and healthcare labor issues. This extensive experience allows for identification of medical and nursing issues in any case that involves health, illness and injury. The clients we serve are attorneys, insurance companies, healthcare facilities and others. At Mid-Valley Legal Nurse Consulting, our goal is to provide our clients with cost-effective, efficient, review and analysis – providing you with winning services while critically defending your bottom-line.
2491 Alluvial #7
Clovis, Ca 93611
Phone: 559-294-7580 or 877-532-5676
Email: midvalleylegalnurseconsulting@gmail.com
http://www.mvlnc.com
http://www.nursingentrepreneurs.com/post/

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See also:

Forensics Nursing, Forensic Nurses http://www.nursingexperts.com/forensics/
Personal Injury Claims Assistance, Legal Nurse Consultants http://www.nursingexperts.com/pi
Darlene Norton, RN, CLNC, Verum Dictum, Inc., Michigan Legal Nurse Consultants:"Legal Nurse Consulting in the areas of: Medical Malpractice, Personal Injury, Toxic Tort and Environmental, Criminal, Products Liability and Class Action Suits."
964 Sugarbush Lane Beulah, Michigan 49617

Contact person: Darleen Norton, President
Phone number: (231) 590-3123
E-mail Address: NurseNorton@hotmail.com
http://www.legalnursingconsultant.org/norton

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American Board of Independent Medical Examiners (ABIME):"The foundation of mission of the American Board of Independent Medical Examiners (ABIME) is the belief that certification of independent medical examiners benefits the public good. This belief is based on the tenet that credentialed physicians have demonstrated that they possess the knowledge, skills, experience, and abilities required for the attainment of their certification as a Certified Independent Medical Examiners, (CIME)TM. Credentials, therefore, are reliable indicators of the professional’s capacity to perform independent medical and impairment evaluations according to the profession’s performance standards. Certification enables the public to make informed decisions regarding the selection and use of independent medical examiners."
111 Lions Drive, Suite 217 Barrington, IL 60010 USA
Telephone: (800) 234-3490 (847) 277-7902 Facsimile: (847) 277-7912, info@ABIME.org
http://www.abime.org/

Sample Independent Medical Examiner Report:
http://www.jurissolutions.com/form3a.shtml

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The "Independent" Medical Examination, Evan K. Aidman, Esq.:"The insurance company has the right in every personal injury case to have you examined by a doctor it chooses. This examination represents the third stage of the discovery process. The insurance lawyers like to refer to this as an "independent medical exam" or an IME. The IME is anything but independent and no insurance lawyer will claim otherwise outside the courtroom, that is, not with a straight face. The doctors paid by the insurance company strain to offer opinions that help the insurance company. Also, the IME doctor’s medical skills may be secondary in importance to his skills at testifying in a compelling and convincing manner."
Evan K. Aidman, Esq.
326 West Lancaster Avenue Ardmore, PA 19003
Phone: (610) 645-0100, Fax: (610) 645-0111.
info@legalaidman.com
http://www.legalaidman.com/9d_indep.htm

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David A. Goodman, M.D., M.P.H., C.I.M.E.:"Certified Independent Medical Examiner by the American Board of Independent Medical Examiners (ABIME). Doctor Goodman has been actively involved in the clinical practice of Urgent Care, Primary Care, and Occupational Medicine in Madison, Wisconsin. He is a pioneer in the field of ambulatory care and opened up Madison’s first Walk-in Medical Clinic in 1983. Over the years he has diagnosed and treated tens of thousands of patients for a variety of injuries and illnesses. He is Board Certified by the American Board of Preventive Medicine and as such is a specialist in the causes of illness and injury. He is dedicated to promoting the health and well-being of our communities."
Dr. Dave Goodman
1658 Sherman Ave., Madison, WI 53704
Phone: (608) 241-0087, Fax: (608) 241-0358
Email: drdave@drdavegoodman.com
http://www.drdavegoodman.com/

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InMedical, Inc.:"InMedical, Inc. is a national provider of Independent Medical Evaluations. Our Independent Medical Evaluations (IME's) are provided with exceptional service, turnaround time and the highest degree of quality. Our personnel are committed to our clients to deliver efficient and accurate medical examination reports under strict time constraints. IME's are provided in association with workers' compensation, personal injury, disability and malpractice claims throughout the United States. We will find any physician specialty you need for your IME."
InMedical, Inc.
405 North Calhoun Road Suite 107 Brookfield, WI 53005
Tel: 262-785-1510 Fax: 262-785-8009 IME: 877-785-1510
info@inmedical.com
http://www.inmedical.com/companyinfo.html

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Why JurisSolutions for Independent Medical Examinations? JurisSolutions.com:"Most Attorneys and Claims Adjusters today simply don't have the time and resources to spend researching the proper physicians and scheduling Independent Medical Examinations (IMEs). With your demanding workload, why not let other attorneys who have years of experience in the IME and expert witness fields handle this burden for you? FAQs on IMEs. Welcome to JurisSolutions, Inc., the most professional and personal IME Company in the field of medical-legal expert witness consulting. We concentrate on liability cases and, as attorneys, we embrace your IME referrals with a thorough understanding of the meaning of a defense-oriented IME. IME Request Form."
JurisSolutions
550 Old Country Road, Suite 407, Hicksville, NY 11801.
Phone: 516.93.JURIS (516.935.8747), Toll Free: 877.935.8750, Fax: 516.935.8748
General email: legalstaff@jurissolutions.com
IME email: ime@jurissolutions.com
http://www.jurissolutions.com/ime.shtml

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FAQs for Independent Medical Evaluations, Jurissolutions.com:"What sets JurisSolutions apart from other IME companies? How do I request an Independent Medical Examination? Do you have Physicians who perform Independent Medical Exams Nationwide? How do you screen your Independent Medical Evaluation physicians? Who notifies Plaintiff’s counsel of the Independent Medical Examination? How soon will you schedule the IME after I make the request? What about testimony? Are your doctors available to testify concerning the Independent Medical Exam if my case reaches trail? Where are you located? Do you conduct seminars? Can I request certain physicians to be used for my IMEs?"
JurisSolutions
550 Old Country Road, Suite 407, Hicksville, NY 11801.
Phone: 516.93.JURIS (516.935.8747), Toll Free: 877.935.8750, Fax: 516.935.8748
General email: legalstaff@jurissolutions.com
IME email: ime@jurissolutions.com
http://www.jurissolutions.com/faq.shtml

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Independent Medical Examinations (IME), Medisys:"Medisys assists corporations and insurance companies in their assessment and management of disability claims. Medisys facilitates decision-making regarding a claimant’s entitlement to benefits and the extent of disability for high cost categories such as Chronic Pain, Fatigue and Fibromyalgia, Heart Disease and Arthritis. In addition, Medbytel’s program of customized questionnaires offers claims examiners the opportunity to supplement the Independent Medical Evaluation process. Medisys’ professional focus ensures that all evaluations are impartial, objective and optimize efficient gathering to decrease turnaround time. Medisys’ Independent Medical Evaluations present a one-stop solution to many of the services required by the Insurance Industry. With service available throughout North America and file review within twenty-four hours, Medisys offers services that are at the forefront of this industry."
Medisys
500 Sherbrooke Street West, 11th Floor Montreal, Quebec H3A 3C6
Tel: (514) 845-1211 Toll free: (800) 499-1394 Fax: (514) 845-4842
E-mail: info@medisys.ca
http://www.medisys.ca/en/independent-medical-examinations.htm

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Unjust Treatment: 'Independent' Medical Examinations & Workers Compensation in New York State, York Committee for Occupational Safety and Health:"Each year approximately 500,000 occupational illnesses and injuries are reported to the New York State Workers' Compensation Board. Of these, several thousand claims for occupational disease are challenged by workers' compensation insurance carriers for reasons that frequently defy close medical analysis and too often defy common sense. With millions of dollars in profit at stake, insurance carriers: challenge valid occupational disease claims, which results in workers often failing to pursue their cases or eventually settling for less than they are entitled to;"
New York Committee for Occupational Safety and Health (NYCOSH)
275 7th Avenue, New York, NY 10001
tel: 212-627-3900; fax: 212-627-9812
email: nycosh@nycosh.org
http://www.nycosh.org/IME_Report1.html

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Independent Medical Examinations, Dr. Samuel M. Rock:"Independent Medical Examinations concentrate on the patient's progress in psychotherapy (whether in the No-Fault arena or the Workmen's Compensation area). I was asked to do an Independent Medical Examination for a law firm. (Usually, IME companies ask for causality connections- which exist between the accident and the mental problems of the claimants. In addition, they usually require the provider to evaluate Maximum Medical Improvement and to determine whether there is a psychological disability.) In this legal case, I was asked to determine if a psychological condition continued to exist within the claimant."
Dr. Samuel M. Rock
96 Old Country Road Melville, NY 11747
(Voice) 631-367-3460 (Toll Free) 877-367-3460 (Fax) 631-424-9627
http://www.docrock.com/IME/ime.html

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Independent Medical Examinations, By Attorney James A. Pitts, Schoone, Leuck, Kelley, Pitts & Knurr, S.C.:"Whenever any person puts his or her mental or physical condition at issue in any case in which compensation is sought, the insurance company or other responsible party defending the case has a right to have a physician of its own choice examine the claimant. The logic of this general rule cannot be questioned. The manner in which so-called "independent medical examinations" are carried out is often fraught with controversy. If the claimant is not properly prepared for what lies ahead, the claim can be lost or seriously damaged. The procedural rules governing independent medical examinations vary among federal and state jurisdictions for tort cases, as well as for cases involving statutory claims such as workers compensation. Several general requirements are universal."
Schoone, Leuck, Kelley, Pitts & Knurr, S.C.
6800 Washington Avenue P.O. Box 085600 Racine, WI 53408-5600
262-886-8240, or e-mail japitts@pittslaw.com
http://my.execpc.com/~japitts/ten.htm

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Independent Medical Examinations (IME), State of Wyoming, Department of Employment:"(a) Medical examinations may be requested by either the Division or your employer. The examination is a medical evaluation of your condition. If an assessment of your permanent physical impairment is required, you will receive an impairment rating. However, the doctor providing this examination/assessment will not be taking over your medical care. You should continue to see your primary health care provider."
Gary W. Child, Administrator
1510 E. Pershing Blvd. Cheyenne, WY 82002
Phone: (307) 777-7441 Fax: (307) 777-6552
http://wydoe.state.wy.us/doe.asp?ID=91

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See also:

--

Any questions, please drop me a line.

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******************************************************

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Wednesday, July 28, 2010

Falls, Slips, Personal Injury, Legal Nurse Consulting on: The Nurse Friendly

Falls, Slips, Personal Injury, Legal Nurse Consulting on: The Nurse Friendly:"The causes of falls are known as risk factors. Although no single risk factor causes all falls, the greater the number of risk factors to which an individual is exposed, the greater the probability of a fall and the more likely the results of the fall will threaten the person's independence."
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/falls.htm

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