Effects of the nursing intervention Fall prevention in older adults with arterial hypertension using NANDA-I, NIC, and NOC.

PURPOSE: To measure the effects of the NIC intervention fall prevention on the magnitude of the NANDA-I Risk for falls' risk factors and of NOC indicators related to falls in older adults with arterial hypertension. BACKGROUND: Nurses can use nursing taxonomies to provide effective care in preventing falls in specific populations. METHODS: Clinical, randomized, open, parallel, and multicenter trial following the CONSORT recommendations for nonpharmacological trials. The clinical trial was registered. The research was conducted with 118 older adults allocated to intervention and control groups and matched by sex and age. The intervention was conducted in the participants' homes in three different moments and consisted of nursing activities belonging to the NIC Fall prevention and implemented with the aid of a protocol with operational definitions. FINDINGS: Three months after the intervention, there was a significant intergroup difference in the frequency of Risk for falls and of the following factors/conditions: cluttered environment, unfamiliar setting, exposure to unsafe weather-related condition, insufficient anti-slip material in the bathroom, history of falls, acute illness, orthostatic hypotension, hearing impairment, and impaired vision. There was also a positive change in the magnitude of the following NOC indicators: risk control, cognitive orientation, knowledge: fall prevention, safe home environment, comfort level, vision compensation behavior, and leisure participation. CONCLUSIONS: The NIC intervention Fall prevention was effective in modifying risk factors belonging to Risk for falls and NOC indicators related to falls in older adults. IMPLICATIONS FOR NURSING PRACTICE: The tested intervention is important and should be instituted, mainly by nurses from primary care services who make home visits to older adults.

Effectiveness of the fall prevention intervention in older adults with arterial hypertension: randomized clinical trial.

OBJECTIVE: To evaluate the effectiveness of the nursing intervention Fall Prevention in reducing falls in older adults with arterial hypertension. METHODS: Pilot clinical trial, with 118 participants with arterial hypertension from a city in the Northeast of Brazil. Participants were allocated by simple randomization into two groups: intervention (n = 58) and control (n = 60). The intervention was carried out at the participants' homes and consisted of guidelines for modifying environmental and behavioral risk factors for falls. A protocol with nursing activities associated with the Fall Prevention intervention proposed in the Nursing Interventions Classification (NIC) taxonomy was used. The outcome was the self-reported occurrence of falls. RESULTS: There was a significant difference between the groups in the frequency of self-reported falls (p=0.38) with fewer falls occurring in the intervention group. Sixteen participants fell, of which 5.1% attributed the fall to difficulty walking, 6.8% fell in the living room, 3.4% had a sprain, and 6.8% reported to be afraid to fall again. CONCLUSION: The nursing intervention Fall Prevention was effective in reducing the occurrence of falls in older adults with arterial hypertension. These findings contribute to the advancement of clinical protocols for the prevention of falls in older adults, as the educational intervention investigated is applicable to different sociodemographic and cultural scenarios.

Analysis of the Nursing Diagnosis Risk for Falls in Older Adults with Hypertension.

OBJECTIVES: To analyze the Nursing Diagnosis risk for falls indicators in aged with hypertension and to verify the association of this diagnosis with sociodemographic variables and antihypertensive agents used by the aged. METHODS: Analytical study, cross-sectional with quantitative approach. It was carried out in three health units in the city of Redenção, Ceará, Brazil, in the Brazilian Northeast. A total of 153 elderly subjects participated in the study. Statistical analysis was performed using Fisher's exact test, Pearson's chi-square test and multinomial logistic regression of variables that presented association with the Nursing Diagnosis. RESULTS: Use of throw rugs, difficulties with gait, acute illness (p = .004), age greater than or equal to 65 years and impaired vision were associated with the Nursing Diagnosis risk for falls (00155). The work situation (retired) was the only sociodemographic variable that had a significant association with the risk for falls. Antihypertensive agents were not associated with the diagnosis. CONCLUSION: Age greater than or equal to 65 years, use of throw rugs, difficulties with gait, acute illness, and impaired vision can be useful to infer the risk for falls and to confirm their presence in the aged with hypertension. IMPLICATIONS FOR NURSING PRACTICE: This study provides data that can help nurses in the process of inferring the diagnosis risk for falls in the aged with hypertension, which streamlines the planning and implementation of preventive interventions.

OBJETIVOS: analisar os elementos estruturais do Diagnóstico de Enfermagem Risco de quedas em idosos com hipertensão arterial e verificar a associação desse diagnóstico com variáveis sociodemográficas e agentes anti-hipertensivos utilizados pelos idosos. MÉTODOS: estudo analítico, transversal com abordagem quantitativa. Foi realizado em três unidades de saúde do município de Redenção, no Nordeste brasileiro. Um total de 153 idosos participaram deste estudo. A análise estatística foi pelo teste exato de Fisher, qui-quadrado de Pearson e a regressão logística multinominal de variáveis que apresentaram associação com o Diagnóstico de Enfermagem. RESULTADOS: uso de tapetes soltos, dificuldades na marcha, doença aguda (p = 0,004), idade maior ou igual a 65 anos e visão prejudicada foram associados ao Diagnóstico de Enfermagem Risco de quedas (00155). A situação de trabalho (aposentado) foi a única variável sociodemográfica que teve associação significante com o Risco de quedas. Os agentes anti-hipertensivos não foram associados ao diagnóstico. CONCLUSÃO: a idade maior ou igual a 65 anos, uso de tapetes soltos, dificuldades na marcha, doença aguda e visão prejudicada podem ser úteis para inferir o Diagnóstico de Enfermagem Risco de quedas e para confirmar sua presença em idosos com hipertensão arterial. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: este estudo fornece dados que podem ajudar o enfermeiro no processo de inferência do diagnóstico Risco de quedas em idosos com hipertensão arterial, o que agiliza o planejamento e a implementação de intervenções preventivas.