RESUMO
PURPOSE: The objective of this study was to identify gaps in and to improve the falls prevention strategy (FPS) of an inpatient rehabilitation facility (IRF) in Toronto, Canada. DESIGN: A modified version of the Stanford Biodesign Methodology was used. METHODS: Chart reviews, a focus group (n = 8), and semistructured interviews (n = 8) were conducted to evaluate the FPS. FINDINGS: Admission Functional Independence Measure score, age, and gender significantly correlated with risk for a fall. The tool used at this IRF was not effectively capturing patients who were at high risk for falls. All healthcare providers interviewed were knowledgeable of fall risks; however, a patient's fall risk status was rarely discussed as a team. CONCLUSIONS: The findings informed recommendations to improve the overall FPS at this IRF. CLINICAL RELEVANCE: Staff may require more coaching for implementing preventative measures/ensuring accountability and evaluating whether current strategies work. These insights can guide improvement initiatives at similar facilities elsewhere.
Assuntos
Acidentes por Quedas/prevenção & controle , Medição de Risco/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pesquisa Qualitativa , Enfermagem em Reabilitação/métodos , Enfermagem em Reabilitação/tendências , Pesquisa Translacional BiomédicaRESUMO
BACKGROUND: Glomuvenous malformations (GVMs) (previously known as glomus tumours) are uncommon, benign, vascular neoplasms. Current treatments include surgical excision and sclerotherapy, often with high recurrence rates and poor cosmetic results. OBJECTIVE: We sought to use a nonsurgical approach for treatment of a GVM. METHODS: We present a patient with an acquired, biopsy-proven GVM of the heel unamenable to surgical excision, treated with a long pulsed 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. RESULTS: Excellent cosmesis and long-term remission were achieved after several treatment sessions. CONCLUSION: Our experience provides further evidence to support the safety and effectiveness of the 1064-nm Nd:YAG laser in the management of large and surgically challenging GVMs.