Living With Intelligent Sensors: Older Adult and Family Member Perceptions.

This qualitative study is part of a larger randomized prospective intervention study that examined the clinical and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. It explored the perceptions of older adults and family members on the sensor system's usefulness, impact on daily routine, privacy, and sharing of health information. This study was conducted in 13 assisted-living facilities in Missouri, and 55 older adults were interviewed. Data were collected over five points in time with a total of 188 interviews. From these five participant interview iterations, the following themes emerged: (1) understanding and purpose, (2) daily life and benefits, (3) impact on privacy, and (4) sharing of information. Three themes emerged from one round of family interviews: (1) benefits of bed sensors, (2) family involvement/staff interaction, and (3) privacy protection versus sensor benefits. The sensor suite was regarded as helpful in maintaining independence, health, and physical functioning. Responses suggest that the willingness to adopt the sensor suite was motivated by both a decline in functional status and a desire to remain independent. Participants were willing to share their health data with providers and select family members. Recommendations for future practice are provided.

Smart medical beds in patient-care environments of the twenty-first century: a state-of-art survey.

BACKGROUND: Recent scientific achievements and technological advances have brought forward a massive display of new or updated medical devices, enabled with highly-developed embedded-control functions and interactivity. From the final decade of the twentieth century, medical beds have particularly been affected by this surge, taking on new forms and functions, while accommodating to established properties that have become well-known for these devices. The past fifteen years have also brought forward changes to conceptual frameworks, concerning the product design and manufacturing processes (standards), as well as the patient (perspectives on patient-care environments and accessibility). This work presents a state-of-art survey on electric medical beds, representing what is defined as the time of "smart beds", as part of an increasingly comprehensive patient-care environment. METHODS: A survey and assessment of market trends, research efforts and standards related to smart medical beds was performed, covering a wide range of public records of intellectual property, models and related healthcare solutions, as well as relevant research efforts in the field between 2000 and 2016. Contextual topics, necessary for the understanding of this subject, on novel technologies, disability and the reach of healthcare systems, were also researched and interpreted. RESULTS: The new generation of electric medical beds is defined, with the final stage of the proposed timeline for these devices being covered. Functional, aesthetic and interactive features are presented, and the current global market for medical beds and related standards are also assessed. Finally, discussions concerning rising challenges and opportunities for these systems are explored, with the potential for adding further monitoring and assistive implementations into medical devices and environments being highlighted. CONCLUSIONS: Smart medical beds are integrated solutions for patient care, assistance and monitoring, based on a comprehensive, multidisciplinary design approach. Research in this field is critical in a context of global ageing, and powered by a surge in opportunities for accessibility solutions. Smart beds, seamlessly integrated into the healthcare system, have a unique opportunity in enabling more efficient efforts for caregivers, and more responsive environments for patients.

Influência do posicionamento do paciente sobre a qualidade das imagens ecocardiográficas em exames realizados no leito / Influence of patient’s positioning on the quality of bedside echocardiography images

Fundamento: O ecocardiograma é particularmente importante para a avaliação de pacientes instáveis hemodinamicamente. Apesar de sua realização à beira do leito eliminar o risco resultante do transporte, a obtenção de imagens pode ficar prejudicada; o posicionamento adequado poderia contribuir para uma melhor qualidade de imagem e consequentemente análise do exame. Objetivo: Avaliar se o posicionamento do paciente pela enfermagem poderia influenciar a qualidade das imagens ecocardiográficas obtidas no leito. Métodos: Foram estudados de maneira consecutiva os pacientes com solicitação de exame no leito. Durante a realização de ecocardiograma transtorácico foram adquiridos vídeos dos planos para esternal longitudinal (PEL) e apical 4-câmaras(Apical-4C) e a imagem estática do fluxo aórtico (FAo) em decúbito lateral esquerdo (DLE) e em decúbito dorsal (DD). As imagens digitalizadas foram analisadas cegamente por dois observadores em relação ao tipo de decúbito utilizado. A qualidade das imagens foi graduada como 1:boa/ótima; 2:inadequada/ruim; e comparadas com o teste de Kappa e correlação de Pearson. Resultados: Foram estudados 68 pacientes, com idade de 69 ± 24 anos, sendo 37 do sexo masculino e superfície corpórea 1,85 ± 0,09 m2. Em relação aos cortes, as imagens em DLE apresentam melhor qualidade (p < 0,001) quando comparadas ao DD tanto para os vídeos Apical-4C (Kappa 0,19) e PEL (Kappa 0,25) e FAo (Kappa 0,13); a concordância entre os avaliadores para a qualidade das imagens foi de 95%. Conclusão: O posicionamento adequado do paciente no leito em decúbito lateral esquerdo contribui significativamente para a aquisição de imagens de melhor qualidade.

Background: Echocardiography is particularly important for assessing hemodynamically unstable patients. Despite being carried out at the bedside to eliminate the risk resulting from patient’s transportation, the imaging maybe impaired. Proper patient’s positioning could contribute to enhancing both the image quality and analysis of the exam. Objective: To evaluate whether patient’s positioning by nurses could influence the quality of the echocardiographic images obtained at the bedside. Methods: Patients whose examinations were requested to be carried out at the bedside were studied in a consecutive manner. During transthoracic echocardiography, videos of the parasternal longitudinal view (PLV) and 4-chamber apical view (Apical-4C) were obtained, as well as the still image of the aortic flow (FAo), in the left lateral decubitus (LLD) and supine decubitus (SD). The scanned images were blindly analyzed by two observers comparing the type of decubitus used. The image quality was rated as 1: good/excellent quality; 2: inadequate/poor, and then submitted to Kappa agreement test and Pearson correlation. Results: 68 patients were studied, aged 69 ± 24 years, 37 males and body surface 1.85 ± 0.09 m2. When the distinct views were compared, LLD images showed better quality (p < 0.001) when compared to SD for both the Apical-4C videos (Kappa 0.19) and PLV (Kappa 0.25) and FAo (Kappa 0.13); interobserver agreement of the quality of the images was 95%. Conclusion: Patient’s proper positioning in bed in left lateral decubitus contributes significantly to the acquisition of better quality images.

The recent fall in postperinatal mortality in New Zealand and the Safe Sleep programme.

AIM: Postneonatal mortality rates changed very little from 2000 until recently. There has been a decrease in mortality in New Zealand from 2009 to 2015. This study describes an infant Safe Sleep programme and postulates it is the cause for the recent decrease in deaths. METHODS: The Safe Sleep programme involved as follows: a focus on preventing accidental suffocation, a 'blitz' approach to SUDI education, the targeted provision of portable infant Safe Sleep devices (ISSD) and the development of Safe Sleep policy across all district health boards (DHBs). RESULTS: Participation in the education 'blitz' by health professionals exceeded one in 23 live births, distribution of Safe Sleep leaflets exceeded two for every live birth, and over 16 500 ISSDs have been distributed to vulnerable infants. Postperinatal mortality fell 29% from 2009 to 2015 (2.8 to 2.0/1000 live births). The fall has been greatest for Maori and in regions with the most intensive programmes. CONCLUSION: The recent fall in postperinatal mortality has not happened by chance. It is likely that the components of end-stage prevention strategy, a focus on preventing accidental suffocation, the education 'blitz', the targeted supply of ISSDs and strengthened health policy, have all contributed to varying degrees.

Pressure redistribution devices: what works, at what cost and what's next?

This article discusses the development and usage of pressure redistribution devices (PRDs) and their impact on the prevention and treatment of pressure ulcers within the NHS. The article outlines the history of the development of these devices and discusses the reasons for a lack of substantial evidence in support of the use of these devices, their impact on the NHS on cost and perceived outcome. The article describes the typical usage profile in a 500 bed NHS hospital and concludes with a view as to how that may change in the future.

Superficie especial del manejo de la presión (SEMP) pediátrica (y II). Elección, algoritmo de asignación (TARISE) y modelos de gestión / Special surfaces for managing pressure in pediatrics (II). Choice, assigned algorithm (TARISE) and management models

Las UPP en la población pediátrica son un efecto adverso provocado por la aplicación de las nuevas tecnologías adaptadas al contexto pediátrico. Las Superficies Especiales del Manejo de la Presión (SEMP) constituyen una medida preventiva eficaz para evitar el desarrollo de estas lesiones. Para que la población pediátrica se vea favorecida por dicha medida se ha de adaptar a sus circunstancias propias. Para ello es fundamental conocer las características diferenciales respecto a la población adulta, los tipos de SEMP pediátricas que nos ofrece el mercado y evaluar su idoneidad y efectividad. El Grupo de Enfermería para la Mejora de la Calidad en Pediatría (GEMCP) del Hospital Clínico Universitario de Valencia ha desarrollado unas herramientas que permiten gestionar y asignar diferentes tamaños y tipos mediante un método científico (Tarise). Se basa en las medidas antropométricas (Tabla Espacio Pediátrico) de cada rango de edad, el riesgo de desarrollar una UPP, la presencia de las mismas, la gravedad de la patología y el tipo de SEMP(AU)

Bed sores among children are an adverse effect provoked by the application of new technology adapted to pediatrics. Special surfaces for managing pressure in pediatrics are a preventive measure effective to avoid the development of these lesions. So that children benefit from this preventive measure, it must be adapted to their specific circumstances. In order for this to occur, it is fundamental to know: the specific characteristics which differentiate children from adults, and the type of special surfaces for managing pressure in pediatrics which are available on the market and to evaluate their appropriateness and effectiveness. The Group of Nurses to Improve Quality in Pediatrics at the University Clinical Hospital in Valencia has developed some tools which make it possible to manage and assign different sizes and types of special surfaces for managing pressure in pediatrics by means of a scientific method (Tarise). These are based on anthropometric measurements (Pediatric Space table) for each age range, the risk to develop a bed sore or skin ulcer due to pressure, the presence of a bed sore, the pathological seriousness and the type of special surfaces for managing pressure in pediatrics(AU)

Superficies especiales para el manejo de la presión / Special surfaces for the management of pressure

Las UPP deben concebirse como un problema multifactorial, pero tiene un peso específico la directa relación existente entre estas lesiones y la presión que se ejerce entre una superficie de apoyo y una zona de prominencia ósea. Por ello la movilización, los cambios posturales, las protecciones locales y el uso de superficies especiales para el manejo de la presión (SEMP) son medidas básicas en su prevención y tratamiento(AU)

Bedsores (UPPs) should be viewed as a multifaceted problem, but the direct relationship which exists between these lesions and the pressure which is exercised between the surface one rests on and a zone having a prominent bone bears significant weight. Therefore, the following are some basic measures which can prevent bedsores: mobility, posture changes, local protection and the use of special surfaces for the management of pressure(AU)

Calidad subjetiva del sueño en personas jubiladas. estudio comparativao de tres colchones / Subjetive sleep quality in retired people. Comparative study of three mattresses

Hay numerosos factores externos e internos que pueden influir en la calidad subjetiva del sueño. El objetivo de este trabajo es examinar la posible relación entre las características físicas de 3 tipos diferentes de colchón (factor externo) y la calidad subjetiva de sueño en personas jubiladas. Se tomó como muestra a 36 sujetos (14 varones y 22 mujeres) con edades comprendidas entre los 56 y los 88 años que vivían habitualmente en una residencia de ancianos. Durmieron según una secuencia de rotación semanal que incluía 3 colchones de diferentes cualidades técnicas y su propio colchón; el total de días de estudio fue de 28. Como instrumentos de medida se utilizaron un cuestionario diario de calidad de sueño, según una escala analógico-visual, una escala semanal de valoración general del colchón asignado y un registro de preferencia final. Se completó el estudio con el registro actigráfico del ciclo sueño-vigilia en 12 de los sujetos. En este grupo de edad, y para las condiciones especificadas, todas las medidas utilizadas fueron tendentes a relacionar la mejor calidad subjetiva de sueño con las características que reunía uno de los colchones utilizados, el identificado como colchón C (AU)

There are many external and internal factors having influence on the subjective quality of sleeping. The main objective of this paper is to examine the possible relation between the physical properties of a mattress (external factor) and the subjective quality of sleeping of retired people. The sample consists of 36 individuals (14 men and 22 women) aged between 56 and 88 living habitually in a retirement house. They slept according to a sequence of weekly rotation of the mattress. This sequence consisted of their own mattress and three new mattresses with very different mechanical properties, adding up 28 days of study. A daily evaluation about sleep quality, with an analogic visual scale, a weekly survey on global evaluation of the assigned mattress and a final record of overall preference were used as measurement devices. The study was completed with the actigrafic measurement of the sleep-awake cycle on 12 of the 36 individuals. For this range of ages and for the specified conditions, every measurement used tent to establish a relation between a better subjective sleep quality and the characteristics of one of the tested mattresses, the one identified as mattress C (AU)

Producing criteria for static mattress tender and purchase.

When selecting mattresses criteria such as health and safety plus clinical and cost-effectiveness should be considered. These can then form the basis of contract tender specifications.

Presentation on assistive technologies for the seating and mobility needs of persons with osteogenesis imperfecta.

Persons with Osteogenesis Imperfecta (OI) are often protected and sheltered because of the fragile nature of their bones. Regardless of the degree of OI. over protecting a person with OI can be just as devastating as fractured bones. It is important that persons with OI are given the opportunity to participate in a wide variety of activities to develop the experiential, physical, and sociological dimensions of their lives. Assistive technology can help to make this participation a reality. Assistive technology should help protect the person from fractures, provide support to assist with postural alignment, and stability so that function and comfort can be enhanced. Technologies such as contoured foam mattresses, seating supports, temperature regulation technologies, orthotic supports, walking and wheelchair mobility devices can enhance the quality of live of people with OI.

Atencion medica hospitalaria en Bolivia / Hospitals medical care in Bolivia

La problematica de los hospitales, constituye una preocupacion permanenete para los sanitarios y administradores de servicios de salud, sin especialidad y es articulada por varios interese, no solo por su inclusion dentro de la red de servicios de salud como establece la Atencion Primaria de Salud. Para enfocar esta problematica se hace necesario conocer la disponibilidad de servicios hospitalarios en Bolivia, actualmente la estructura de esta disponibilidad por subsectores y departamentos, las variaciones de la demanda de atencion por egresos en ciertos periodos de informacion disponibles y el rendimiento de camas hospitalarias y otros indicadores correspondientes. De los estudios realizados hasta la fecha se presentan el diagnostico situacional de los Hospitales en Bolivia y el Resumen de problemas y propuestas de soluciones