Nursing care for hospitalized older adults - fall accidents versus safe mobility: a scoping review.
Esther Mourão Nicoli, Frances Valéria Costa E Silva, Luciana Guimarães Assad and 3 others
PMID 39045975WHAT IT FOUND
Restricting older patients' movement to prevent falls often causes more harm than good.
Safe mobility requires assessing individual risks and removing barriers like IV lines or bed alarms, rather than relying on blanket bed rest.
Key findings
01Interventions that limit mobility, such as bed rest or signaling bracelets, can lead to functional decline, increased hospital stay, and higher risk of future falls.
02Ten days of bed rest in older adults reduces aerobic capacity by approximately 12% and knee extensor strength by 16%.
03Safe mobility involves assessing intrinsic factors and removing treatment devices that hinder walking, such as intravenous catheters and indwelling bladder catheters.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review mapped concepts but did not quantify the effectiveness of specific interventions. Few studies provided a clear definition of 'safe mobility,' leading to heterogeneity in how the concept was applied. The review did not deeply analyze drug therapy or specific cognitive and emotional aspects affecting mobility. Searches were limited to a simple number of gray literature sources, potentially missing some unpublished data.
Declared interests
The study was funded by FAPERJ and CAPES (Brazilian government agencies) for a master's student. No commercial conflicts of interest were reported.
The easy way to misread this
Do not interpret this review as evidence that any specific mobility protocol prevents falls. It maps the components of 'safe mobility' but does not prove that implementing these components reduces fall rates compared to standard care.