Identifying risks the safety of elderly patients with dementia: integrative review
DOI:
https://doi.org/10.33448/rsd-v9i9.7877Keywords:
Aged; Alzheimer's disease; Dementia; Patient safetyAbstract
This is an integrative review study with the objective of identifying the risks to the safety of elderly patients with dementia. The research took place in the Medline, Bdenf and Lilacs databases, covering complete articles in electronic format, in english, Portuguese and Spanish in the period from 2015 to 2020. After the analysis according to the study criteria, 29 articles were selected that constituted the sample of this review. The risks found were analyzed from the perspective of patient safety and described in eight categories involving the international patient safety goals of the World Health Organization, the risks of functional losses related to cognitive deterioration, the risks of functional loss associated with psychological changes and behavioral of dementia and security risks associated with hospitalization. The identification of security risks for the elderly with dementia is fundamental for the management of safe care. The progression of cognitive deficit predisposes the elderly individual with dementia to risks that can be prevented or mitigated through the perspective of patient-centered care.
References
Anvisa. (2013). Assistência segura: Uma reflexão teórica aplicada a prática. Website da Agência Nacional de Vigilância Sanitária (Anvisa). http://www.saude.pr.gov.br/arquivos/File/0Seguranca_do_Paciente/Modulo_1Assist enciaSegura.pdf
Anvisa (2015). – RDC No 26, DE 02 DE JULHO DE 2015. 4. http://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2015/rdc0026_26_06_2015.pdf
Abellard J, Rodgers C & Bales A.L. (2017). Balancing sexual expression and risk of harm in elderly persons with dementia. J Am Acad Psychiatry Law.45(4):485-492.
Assato, C P & Oliveira C R B. (2015) Psicofarmacos potencialmente inapropriados para idosos. Estudos interdisciplinaes Envelhecimento. 20 (3):687-701, dez.2015
Bantry White E & Montgomery P. (2016) Supporting people with dementia to walkabout safely outdoors: development of a structured model of assessment. Health Soc Care Community. 24(4):473-484. doi:10.1111/hsc.12226
Behrman S, Wilkinson P, Lloyd H & Vincent C. (2017) Patient safety in community dementia services: what can we learn from the experiences of caregivers and healthcare professionals? Age and Ageing. May;46(3):518-521. DOI: 10.1093/ageing/afw220.
Berry B & Apesoa-Varano EC. (2017) Medication takeovers: Covert druggings and behavioral control in Alzheimer's. Soc Sci Med. 188:51-59. doi:10.1016/j.socscimed.2017.07.003
Cipriani G, Danti S., Picchi L, Nuti A & Di Fiorino M. (2020) Daily functioning and dementia. Dement Neuropsychol June.14(2): 93-102.
Coahran M, Hillier LM, Van Bussel L, et al. (2018) Automated Fall Detection Technology in Inpatient Geriatric Psychiatry: Nurses' Perceptions and Lessons Learned. Can J Aging. 37(3):245-260. doi:10.1017/S0714980818000181
Dourado M, Laks J, Rocha M., Soares C, Leibing A & Engelhardt E (2005) Consciência da doença na Demência Resultados preliminares em pacientes com doença de Alzheimer leve e moderada. Arq Neuropsiquiatr 2005;63(1):114-118
Dudevich A, Husak L, Johnson T & Chen A (2018). Safety and Quality of Care for Seniors Living with Dementia. Healthc Q.;21(3):12-15. doi:10.12927/hcq.2018.25708
Evans EA, Perkins E, Clarke P, Haines A, Baldwin A, & Whittington R. (2018). Care home manager attitudes to balancing risk and autonomy for residents with dementia. Aging Ment Health. 22(2):261-269. doi:10.1080/13607863.2016.1244803
Freitas E. V., Py L, Cançado F. A. X., Doll J. Gorzoni M. L. (2011). Tratado de Geriatria e Gerontologia. 3.ed. Ed Guanabara Koogan.
Green YS. Safety Implications for the Homebound Patient With Dementia. Home Healthc Now. 2018;36(6):386-391. doi:10.1097/NHH.0000000000000701
Grupo Anima Educação. (2014). Manual de Revisão Bibliográfica Sistemática Integrativa: A pesquisa baseada em evidências. Belo Horizonte. http://biblioteca.cofen.gov.br/wpcontent/uploads/2019/06/manual_revisao_bibliografica-sistematica-integrativa.pdf
Häikiö, Kristin; Sagbakken, Mette & Rugkåsa, Jorun.. (2019) Dementia and patient safety in the community: a qualitative study of family carers' protective practices and implications for services. BMC Health Serv Res ; 19(1): 635
Hunter KF, Parke B, Babb M, Forbes D & Strain L (2017). Balancing safety and harm for older adults with dementia in rural emergency departments: healthcare professionals' perspectives. Rural Remote Health.;17(1):4055. doi:10.22605/rrh4055
Hernández-Arroyo, M & Díaz-Madero A. (2016) Valoración del riesgo/benefício en el tratamiento de la enfermedad de Alzheimer. A propósito de una interacción. Revista Española de Geriatría y Gerontología Volume 51, Issue 4, Pages 191-195 Doi 10.1016/j.regg.2015.11.006
Hussain M, Ali T, Khan WA, Afzal M, Lee S & Latif K. (2015) Recommendations service for chronic disease patient in multimodel sensors home environment. Telemed J E Health.;21(3):185-199. doi:10.1089/tmj.2014.0028
Karuncharernpanit S, Hendricks J & Toye C. (2016) Perceptions of exercise for older people living with dementia in Bangkok, Thailand: an exploratory qualitative study. Int J Older People Nurs.;11(3):166-175. doi:10.1111/opn.12091
Luxford K, Axam A, Hasnip F, et al (2015). Improving clinician-carer communication for safer hospital care: a study of the 'TOP 5' strategy in patients with dementia. Int J Qual Health Care.;27(3):175-182. doi:10.1093/intqhc/mzv026
Lau WM, Chan TY & Szeto SL. ( 2019) Effectiveness of a home-based missing incident prevention program for community-dwelling elderly patients with dementia. Int Psychogeriatr. 31(1):91-99. doi:10.1017/S1041610218000546
Lee L & Molnar F. (2017) Driving and dementia: Efficient approach to driving safety concerns in family practice. Can Fam Physician.63(1):27-31.
Levy-Storms L, Cherry DL, Lee LJ & Wolf SM. (2017) Reducing safety risk among underserved caregivers with an Alzheimer's home safety program. Aging Ment Health.;21(9):902-909. doi:10.1080/13607863.2016.1181710
Ministério da Saúde. (2013a). Anexo 01: Protocolo para a Prática de Higiene das Mãos em serviços de Saúde. 37. https://proqualis.net/sites/proqualis.net/files/000002347fQHsQg.pdf
Ministério da Saúde. (2013b). Anexo 02: Protocolo de identificação do paciente. http://www.saude.gov.br/images/pdf/2014/julho/03/Protocolo---Identifica----o-do-Paciente.pdf
Ministério da Saúde. (2013c). Anexo 03: Protocolo de Segurança na Prescrição, Uso e Administração de Medicamentos.
https://edisciplinas.usp.br/pluginfile.php/4563327/mod_resource/content/1/2013%20Protocol o%20de%20seguran%C3%A7a.pdf
Ministério da Saúde. (2013d). Anexo 02: Protocolo Para Prevenção De Úlcera Por Pressão http://www.saude.gov.br/images/pdf/2014/julho/03/PROTOCOLO-ULCERA-POR-PRESS--O.pdf
Ministério da Saúde. (2013e). Anexo 01: Protocolo Prevenção De Quedas https://Proqualis.Net/Sites/Proqualis.Net/Files/Protocolo%20%20Preven%C3%A7%C3%A3o%20de%20Quedas.Pdf
Ministério da Saúde. (2013f). Portaria no. 529, de 1 de abril de 2013. Institui o Programa Nacional de Segurança do Paciente (PNSP).
http://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html
Ministério da Saúde, & Fundação Oswaldo Cruz. (2014). Documento de referência para o Programa Nacional de Segurança do Paciente.
http://bvsms.saude.gov.br/bvs/publicacoes/documento_referencia_programa_nacional_segura nca.pdf
Ministério da Saúde. (2016) Secretaria de Atenção à Saúde. Departamento de Atenção Hospitalar e de Urgência. Segurança do paciente no domicílio / Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Hospitalar e de Urgência. – Brasília : Ministério da Saúde
http://bvsms.saude.gov.br/bvs/publicacoes/seguranca_paciente_domicilio.pdf
Miller, L. M., Whitlatch, C. J., Lee, C. S., & Lyons, K. S. (2018). Incongruent perceptions of the care values of hospitalized persons with dementia: a pilot study of patient-family caregiver dyads. Aging & mental health, 22(4), 489–496. doi.org/10.1080/13607863.2017.1280766
Montastruc F, Rouanet S, Gardette V, Rousseau V, Bagheri H & Montastruc JL (2015). Atropinic burden of prescriptions forms in patients with Alzheimer disease: a cross-sectional study in a French PharmacoVigilance Database. Eur J Clin Pharmacol.;71(7):891-895. doi:10.1007/s00228-015-1869-0
Mao HF, Chang LH, Yao G, Chen WY & Huang WN. (2015). Indicators of perceived useful dementia care assistive technology: Caregivers' perspectives. Geriatr Gerontol Int.;15(8):1049-1057. doi:10.1111/ggi.12398
Marinho C L, Nascimento V., Bonadiman B. S. R. & Torres S. R. F. (2020). Causas e consequências de quedas de idosos em domicílio. Braz. J. Hea. Rev., Curitiba, v. 3, n. 3, p. 6880-6896
North C. (2016) Comprehensive geriatric assessment of a mental health service user with safeguarding needs. Nurs Older People.;28(5):25-29. doi:10.7748/nop.28.5.25. s25
Oliveira MG, Amorim WW, Oliveira CRB, Coqueiro HL, Gusmão LC, Passos LC. (2016) Consenso brasileiro de medicamentos potencialmente inadequados para idosos. Geriatr Gerontol Aging. 10 (4): 168-181
Pastor DK, Arms T & Jones AL. (2018) Red Flags and Off Ramps: Providing Community Education About Driving and Dementia. Home Healthc Now.;36(5):319-323. doi:10.1097/NHH.0000000000000695
Rahja, M, Comans, T, Clemson, L, Crotty, M & Laver, K (2018) Are there missed opportunities for occupational therapy for people with dementia? An audit of practice in Australia. Australian Occupational Therapy Journal 65 Doi;10.1111/1440-1630.12514
Sharp, Catherine A; Schulz Moore, Jennifer S; McLaws & Mary-Louise. (2019) Two-Hourly Repositioning for Prevention of Pressure Ulcers in the Elderly: Patient Safety or Elder Abuse? J Bioeth Inq ; 16(1): 17-34.
Silva, M., Sá, L., & Sousa, L. (2018). Efcácia dos programas psicoeducacionais na sobrecarga nos familiares cuidadores de pessoas com demência: Revisão integrativa. Revista Portuguesa de Enfermagem de Saúde Mental (19), 54-60. doi: 10.19131/rpesm.0202
Sinvani L, Strunk A, Patel V, et al. (2019) Constant Observation Practices for Hospitalized Persons With Dementia: A Survey Study. Am J Alzheimers Dis Other Demen.;34(4):223-230. doi:10.1177/1533317519826272
Tudor Car, L., El-Khatib, M., Perneczky, R. et al. Prioritizing problems in and solutions to homecare safety of people with dementia: supporting carers, streamlining care. BMC Geriatr 17, 26 . doi:10.1186/s12877-017-0415-6
Taylor J, Hill H & Kay K. (2016) An integrated practice approach to mobility care for older people. Nurs Stand.;30(29):51-60. doi:10.7748/ns.30.29.51. s47
Thomas S. & Mackintosh S. (2016) Improvement of physical Therapist assessment of risk of falls in the hospital and discharge handover through an intervention to Modify clinical behavior. Phys Ther. 2016; 96:764–773.
Organização Mundial De Saúde (2016). Guia curricular de Segurança do paciente da Organização Mundial da Saúde. Edição multiprofissional/ Coordenação de Vera Neves Marra, Maria de Lourdes Sette. — Rio de Janeiro:
Organização Mundial De Saúde (2015) - Relatório mundial de envelhecimento e saúde. https://apps.who.int/iris/bitstream/handle/10665/186468/WHO_FWC_ALC_15.01_por.pdf;jsessionid=6F2D8D380265912B4B3F20F1918A240C?sequence=6
Organização Mundial de Saúde (2017) Global action plan on the public health response to dementia 2017–2025 ISBN 978-92-4-151348-7
https://www.who.int/mental_health/neurology/dementia/action_plan_2017_2025/en/
Yang YT & Kels CG. (2016) Does the Shoe Fit? Ethical, Legal, and Policy Considerations of Global Positioning System Shoes for Individuals with Alzheimer's Disease. J Am Geriatr Soc. 2016;64(8):1708-1715. doi:10.1111/jgs.14265
Who. 2018. Falls. Disponível em: https://www.who.int/news-room/fact-sheets/detail/falls
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Doralice das Graças de Melo Calvo; Ana Karine Ramos Brum; Claudia Maria Messias
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.