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Posluszny KM, Ho DC, Veerasammy S, Taylor C, McDougall R, Fischer SL. A mixed methods approach to describe the efficacy of lift assist device use to reduce low back musculoskeletal disorder risk factors during three common patient extrication scenarios. APPLIED ERGONOMICS 2024; 121:104361. [PMID: 39067283 DOI: 10.1016/j.apergo.2024.104361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
This mixed-method study evaluated the efficacy of lift assist device use (Binder®, Eagle®, Maxi Air®) relative to manual lifting/care-as-usual in reducing low back muscle activity and perceived exertion during simulated patient extrication tasks. User feedback was recorded to identify factors that might influence use. Twenty paramedics performed a floor to stretcher lift, lateral transfer, and confined space extrication care-as-usual and with lift assist devices. Use of a lift assist reduced low back muscle activity during floor to stretcher and confined space tasks by 34-47%. Paramedics perceived exertion decreased from 'somewhat hard' to 'light' or 'very light' when using an assistive device. Paramedics noted that ease of use, patient comfort, task time, patient acuity, among other considerations would influence use decisions. Lift assist devices were efficacious at reducing low back muscle activity and perceived exertion during floor to stretcher and patient extrication tasks.
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Affiliation(s)
- Kate M Posluszny
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Daphne C Ho
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Sanjay Veerasammy
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Cindi Taylor
- Niagara Emergency Medical Services, Niagara Falls, Canada
| | | | - Steven L Fischer
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada.
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Watkins P, Buzzacott P, Tohira H, Finn J, Brink D, Brits R, Hill AM. "Mind the gap": An exploratory qualitative study of paramedics' experiences attending older adults who fall in Western Australia. Australas Emerg Care 2024; 27:177-184. [PMID: 38238144 DOI: 10.1016/j.auec.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/22/2023] [Accepted: 01/10/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE To explore paramedics' experiences and perspectives about attending and managing older adults who had fallen. PROCEDURES This qualitative, exploratory study used a purposive sample of paramedics in Western Australia. Participants had at least one year of clinical experience. Semi-structured interviews were undertaken. Data were analysed via an inductive thematic approach. FINDINGS Fourteen paramedics were interviewed (Median age: 38 years, n = 5 females). The main theme identified that experiences were positive when attending patients with high-acuity medical problems or injuries following falls because binary decision-making (transport vs non-transport) was appropriate. Themes highlighted that decision-making for low-acuity falls attendances was a complex balance between 1) patient context, 2) risk management, 3) paramedic reactions, and 4) the lack of alternate referral pathways available. Experiences could be stressful and frustrating when attending falls call-outs for older adults with no injuries or medical problems. Participants concurred that when transport to hospital was not required there were no available, alternative pathways to refer onwards for appropriate health or social care. CONCLUSION Attending low-acuity call-outs for falls was often frustrating and required complex decision-making, with gaps in services identified. Further exploration of alternative referral pathways for health care for pre-hospital management of adults who fall is required.
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Affiliation(s)
- Paige Watkins
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia.
| | - Peter Buzzacott
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
| | - Hideo Tohira
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia; Discipline of Emergency Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Judith Finn
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia; Discipline of Emergency Medicine, Medical School, The University of Western Australia, Perth, Western Australia, Australia; St John WA, Belmont, Western Australia, Australia
| | - Deon Brink
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Western Australia, Australia
| | - Rudi Brits
- St John WA, Belmont, Western Australia, Australia
| | - Anne-Marie Hill
- School of Allied Health, WA Centre for Health & Ageing, The University of Western Australia, Perth, Western Australia, Australia
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Watkins PM, Hill AM, Tohira H, Brink D, Finn J, Buzzacott P. Epidemiology of ambulance-attended adults who fell in Western Australia 2015 - 2021: An increasing incidence in an ageing population. Injury 2023; 54:111035. [PMID: 37777369 DOI: 10.1016/j.injury.2023.111035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Emergency Medical Services (EMS) are attending an increasing number of adults who fall. This study aimed to describe the incidence, patient characteristics, treatments and disposition of ambulance attended patients who fell in Western Australia (WA). METHODS An ordinal logistic regression (using STATA) was conducted in this retrospective cohort study, analysing predictors of lower compared to higher transport urgency levels. Participants were adults ( ≥ 18 years) who fell and required ambulance attendance in WA between 1st January 2015 - 31st December 2021. RESULTS A total of 188,720 patients (female = 107,811, 57 %) were attended by ambulances after falls, (median age = 80 years [IQR 67-87]). The age-standardized incidence rate of ambulance attended falls increased from 115 cases/100,000 person-years to 161 cases/100,000 person-years between 2015 and 2021. A total of 89,140 (47 %) patients had an injury recorded by paramedics, most often lacerations or suspected fractures. The electronic patient care record showed, 50,044 (26.5 %) patients received medication and 30,954 (16.4 %) patients received other intervention, e.g., ECG. A total of 148,050 (78 %) patients were transported to hospital with the following urgency levels: 2,371 (2 %) via urgency one; 27,882 (19 %) via urgency two, 93,447 (63 %) via urgency three and 22,584 (15 %) via urgency four and five ( < 1 % unknown urgency). Positive predictors of lower level transport urgency to hospital included being female and older than 65 years of age. CONCLUSION Older, female patients had higher odds of being transported via a lower urgency, with 50 % of this cohort transported via urgency three. While 19 % of patients were attended via a Priority one, only 1 % were transported to hospital via urgency one. The incidence rate of falls requiring ambulance attendance has increased over time, increasing the demand placed on EMS annually.
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Affiliation(s)
- Paige M Watkins
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Australia.
| | - Anne-Marie Hill
- School of Allied Health, University of Western Australia, Perth, Australia
| | - Hideo Tohira
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Australia; Discipline of Emergency Medicine, Medical School, The University of Western Australia, Perth, Australia
| | - Deon Brink
- St John Western Australia, Belmont, Australia
| | - Judith Finn
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Australia; St John Western Australia, Belmont, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Buzzacott
- Prehospital Resuscitation and Emergency Care Research Unit (PRECRU), Curtin School of Nursing, Curtin University, Perth, Australia
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Farhat H, Aifa KE, Alinier G, Nashwan A, Gangaram P, Khadhraoui M, Al-Shaikh L, Gargouri I, Laughton J. Understanding patient non-transport decision theories in the pre-hospital setting: a narrative review. Int J Emerg Med 2023; 16:69. [PMID: 37821810 PMCID: PMC10566180 DOI: 10.1186/s12245-023-00528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In pre-hospital emergency care, decisions regarding patient non-conveyance emerged as significant determinants of healthcare outcomes and resource utilization. These complex decisions became integral to the progress of emergency medical services, thus warranting an evolving exploration within the medical discourse. OBJECTIVES AND METHODS This narrative review aimed to synthesize and critically evaluate various theoretical stances on patient non-conveyance in the pre-hospital emergency. The focus on studies published between January 2012 and August 2022 was intentional to capture contemporary practices and insights. PubMed and Google Scholar served as the primary databases for the investigation, while the AL-Rayyan® software facilitated a thorough screening process. RESULTS AND DISCUSSION Twenty-nine studies-encompassing articles, books, and theses-were discovered through our search, each presenting unique perspectives on patient non-transport, thus highlighting its criticality as a healthcare concern. Predominant factors influencing non-transport decisions were classified into patient-initiated refusals (PIR), clinician-initiated decisions (CID), and dispatcher-initiated decisions (DID). CONCLUSIONS The issue of patient non-conveyance to hospitals continues to pose a crucial challenge to the seamless operation of emergency healthcare systems, warranting increased attention from various healthcare entities. To comprehend and pinpoint potential areas of improvement, a comprehensive analysis of pre-hospital non-transport events is imperative. A well-informed, strategic approach could prevent resource waste while ensuring patients receive the required and definitive care. KEY MESSAGES Why is this topic important? Some studies have suggested that non-transport to hospitals following emergency calls is safe. However, it is a concerning issue for health systems. It is also considered a key performance metric for health systems. What does this review attempt to show? This review aimed to map the various factors discussed in the literature regarding the decisions not to transport patients following emergency calls in a pre-hospital setting. What are the key findings? The existing theories regarding non-transport to hospitals after the provision of emergency care in the pre-hospital setting were identified. Non-transport due to non-clinical decisions jeopardizes emergency care outcomes for paediatric and elderly patients in particular. Hence, further research is required to identify and control the factors governing these decisions. How is patient care impacted? The decisions regarding patient transport following emergency calls in a pre-hospital setting are crucial for patient outcomes. They could impact the pre-hospital emergency care outcomes as well as patient safety. They can also affect the emergency services resources' ability to respond to other critical emergencies.
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Affiliation(s)
- Hassan Farhat
- Hamad Medical Corporation Ambulance Service, Doha, Qatar
- Faculty of Sciences, University of Sfax, 3000, Sfax, Tunisia
- Faculty of Medicine of Sousse "Ibn El Jazzar", University of Sousse, 4000, Sousse, Tunisia
| | | | - Guillaume Alinier
- Hamad Medical Corporation Ambulance Service, Doha, Qatar.
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK.
- Weill Cornell Medicine-Qatar, Doha, Qatar.
- Northumbria University, Newcastle Upon Tyne, UK.
| | | | - Padarath Gangaram
- Hamad Medical Corporation Ambulance Service, Doha, Qatar
- Faculty of Health Sciences, Durban University of Technology, PO Box 1334, Durban, 4000, South Africa
| | - Moncef Khadhraoui
- Higher Institute of Biotechnology, University of Sfax, Sfax, Tunisia
| | - Loua Al-Shaikh
- Hamad Medical Corporation Ambulance Service, Doha, Qatar
| | - Imed Gargouri
- Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - James Laughton
- Hamad Medical Corporation Ambulance Service, Doha, Qatar
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Karpusenko T, Alfonsi M, Cirino NTDO, Ishigaki EY, Sanudo A, Paschoal SMP, Leme LEG, Perracini MR. Factors associated with unrecovered falls among older adults. Geriatr Nurs 2023; 51:323-329. [PMID: 37084686 DOI: 10.1016/j.gerinurse.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 04/23/2023]
Abstract
This cross-sectional exploratory study investigated factors associated with unrecovered falls among older patients with a history of falls in the previous year participating in a clinical trial on fall prevention by asking them about their inability to get up independently after the fall. Participants' sociodemographic, clinical, functional (ADL/IADL, TUG, chair-stand test, hand grip, risk of falling) and fall location were investigated. We conducted a multivariate regression analysis adjusted for covariates to identify the main factors associated with unrecovered falls. Out of 715 participants (mean age: 73.4 years; 86% women), 51.6% (95% IC; 47.9 - 55.3%) experienced unrecovered falls. Depressive symptoms, ADL/IADL limitation, mobility limitation, undernutrition, and outdoor falls were associated with unrecovered falls. While assessing the risk of falling, professionals should consider preventive strategies and preparedness procedures for those who are more likely to experience unrecovered falls, such as training to get up from the floor, alarms, and support services.
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Affiliation(s)
- Tatiana Karpusenko
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil
| | - Maynara Alfonsi
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil.
| | - Nayara Tasse de Oliveira Cirino
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil; Department of Physical Therapy, Universidade de Cuiabá, Avenida Virgílio Favetti, 1200, Zip code: 78.306-211, Tangará da Serra, Mato Grosso, Brazil
| | - Erika Yukie Ishigaki
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil; Centro Universitário Faculdade de Medicina do ABC, Avenida Lauro Gomes, 2000, Zip code: 09060-870, Santo André, Brazil.
| | - Adriana Sanudo
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil; Department of Preventive Medicine, Universidade Federal de São Paulo, Rua Botucatu, 740, Zip code: 04023-062, São Paulo, Brazil
| | - Sergio Marcio Pacheco Paschoal
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil
| | - Luiz Eugênio Garcez Leme
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil; Institute of Orthopedics and Traumatology, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil.
| | - Monica Rodrigues Perracini
- PrevQuedas Brazil Research Group, Faculty of Medicine, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, Zip code: 05403-010, São Paulo, Brazil; Master's and Doctoral Programs in Physical Therapy, Rua Cesáreo Galeno, 448, Zip code: 03071-000, São Paulo, Brazil; Master's and Doctoral Programs in Gerontology, Rua Tessália Vieira de Camargo, 126, Zip code: 13083-887, Campinas, Brazil.
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The prehospital management of ambulance-attended adults who fell: A scoping review. Australas Emerg Care 2023; 26:45-53. [PMID: 35909044 DOI: 10.1016/j.auec.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The ageing population is requiring more ambulance attendances for falls. This scoping review aimed to map and synthesise the evidence for the prehospital management of Emergency Medical Services (EMS) attended adult patients who fall. METHODS The Joanna Briggs Institute methods for scoping reviews were used. Six databases were searched (Medline, Scopus, CINAHL, Cochrane, EMBASE, ProQuest), 1st August 2021. Included sources reported: ambulance attended (context), adults who fell (population), injuries, interventions or disposition data (concept). Data were narratively synthesised. RESULTS One-hundred and fifteen research sources met the inclusion criteria. Detailed information describing prehospital delivered EMS interventions, transport decisions and alternative care pathways was limited. Overall, adults< 65 years were less likely than older adults to be attended repeatedly and/or not transported. Being male, falling from height and sustaining severe injuries were associated with transport to major trauma centres. Older females, falling from standing/low height with minor injuries were less likely to be transported to major trauma centres. CONCLUSION The relationship between patient characteristics, falls and resulting injuries were well described in the literature. Other evidence about EMS management in prehospital settings was limited. Further research regarding prehospital interventions, transport decisions and alternative care pathways in the prehospital setting is recommended.
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Jeruzal JN, Boland LL, Jin D, Traczyk CL, Shippee ND, Neprash HT, Stevens AC. Trends in fall-related encounters and predictors of non-transport at a US Emergency Medical Services Agency. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1835-e1843. [PMID: 34676630 DOI: 10.1111/hsc.13613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/17/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
Non-transport to a hospital after emergency medical services (EMS) encounters for falls is common. However, incident factors associated with non-transport have not been well studied, especially beyond older adults. The objectives of this study are to (1) describe trends in fall-related EMS utilisation among adult patients from 2010 to 2018; (2) describe incident characteristics by age; and (3) identify incident factors associated with non-transport following a fall. This retrospective observational study includes prehospital clinical records data on falls from a large ambulance service in Minnesota, USA. Multivariable logistic regression was used to assess the independent association between non-transport and the following factors: sex, age, race, previous fall-related EMS encounter, incident location and primary impression. Of 62,835 fall-related encounters studied, 14.7% (9,245) did not result in transport by EMS. Fall calls were less common among younger people and the location and medical conditions primarily treated by an EMS provider during a 9-1-1 call differed greatly from those occurring among patients 65 and older. Factors most strongly associated with an increased risk of non-transport in the multivariable model were a primary impression of 'No apparent illness/injury' (OR = 34.5, 95% CI = 30.7-38.7), falling in a public location (OR = 2.09, CI = 1.96-2.22) and having had a fall-related EMS encounter during the prior year (OR = 1.15, CI = 1.1-1.2). Falls that occur in public locations, in patients with a previous fall, or result in no clinical detection of apparent illness or injury have a significantly increased odds of non-transport. Non-transport fall incidents in the United States require significant agency resources. Knowledge about the incident factors associated with non-transport calls is informative for development of alternative models for prehospital care delivery and initiatives to better serve patients.
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Affiliation(s)
- Jessica N Jeruzal
- Department of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lori L Boland
- Allina Health Emergency Medical Services, St. Paul, MN, USA
| | - Diana Jin
- Allina Health Emergency Medical Services, St. Paul, MN, USA
| | | | - Nathan D Shippee
- Department of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Hannah T Neprash
- Department of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Bouzid W, Tavassoli N, Berbon C, Qassemi S, Bounes V, Azema O, Shourick J, Nourhashémi F. Impact of a personalised care plan for the elderly calling emergency medical services after a fall at home: The RISING-DOM multi-centre randomised controlled trial protocol. BMC Geriatr 2022; 22:182. [PMID: 35246053 PMCID: PMC8894840 DOI: 10.1186/s12877-022-02850-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND A growing number of emergency calls are made each year for elderly people who fall. Many of them are not taken to hospital or are rapidly discharged from the Emergency Department (ED). Evidence shows that, with no further support, this vulnerable population is particularly at risk of injuries, dependency and death. This study aims to determine the effectiveness of a comprehensive geriatric assessment and a tailored intervention in the elderly calling on an Emergency Medical Service (EMS) for a fall at home, but not conveyed to the ED or rapidly discharged from it (less than 24 h from hospitalisation), to the time to institutionalisation or death. METHODS Rising-Dom is a two-arm randomised (ratio 1:1), interventional, multi-centre and open study. Community-dwelling elderly people (≥ 70 years) who call an EMS for a fall at home are recruited. The intervention group receives home visits by a nurse with a comprehensive fall risk assessment and a personalised intervention care plan with a planned follow-up (six nurse home visits and five nurse phone calls). Subjects enrolled in the usual care-control group continue to receive their routine care for the prevention or treatment of diseases. Primary (time to institutionalisation or death) and secondary (unscheduled hospitalisations, additional EMS calls relating to falls, functional decline and quality of life) outcome data will be collected for both groups through five phone calls made by Clinical Research Associates (CRA) blind to the participants' group during the follow-up period (24-months). Twelve hospital centres in the South-West of France are participating in the study as study sites. The inclusion period started in October 2019 and will end in March 2022. By the end of this period, 1,190 subjects are expected to be enrolled. DISCUSSION Studies on elderly home falls have rarely concerned people who were not taken to hospital. The Rising-Dom intervention scheme should enhance understanding of features related to this vulnerable population and investigate the impact of a nurse care at home on delaying death and institutionalisation. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT04132544. Registration date: 18/10/2019. SPONSOR University Hospital, Toulouse. https://www.clinicaltrials.gov/ct2/show/NCT04132544?term=rising-dom&draw=2&rank=1.
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Affiliation(s)
- Wafa Bouzid
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Neda Tavassoli
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Caroline Berbon
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Soraya Qassemi
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Vincent Bounes
- Pôle Médecine d'Urgence, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Olivier Azema
- Observatoire Régional Des Urgences d'Occitanie (ORU Occitanie), Hôpital La Grave, Place Lange, 31300, Toulouse, France
| | - Jason Shourick
- Unité de Soutien Méthodologique À La Recherche (USMR), Service d'Epidémiologie Clinique Et de Santé Publique, CHU de Toulouse, Toulouse, France
- CERPOP, UMR 1295, INSERM - Université de Toulouse III, Toulouse, France
| | - Fati Nourhashémi
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- CERPOP, UMR 1295, INSERM - Université de Toulouse III, Toulouse, France
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