This study seeks to identify the impact of structured communication between Registered nurses (RNs) and Unlicensed Assistive Personnel (UAP) to decrease the fall rate and number of injurious falls on a Medical-Surgical unit. A seven item tool addressing fall risks (pocket card) will be utilized to communicate fall risks on admission, at hand off of care, and every 4 hrs.
Falls are extremely common. For persons over the age of 65, 25% will fall in any given year. Falls are the leading cause of accidental death in the elderly. Risk factors for falling include previous history of falling, gait and balance difficulties, lower extremity weakness, cognitive dysfunction, peripheral neuropathy and other conditions. Many non-injurious falls go unreported but they present a significant risk factor for the identification of individuals at risk for subsequent falls. We propose a small installation (less than 10 units) of our fall detection system at Still Hopes retirement community and track both reported falls as well as falls as detected by our system. We will use this data for validation of our system. Gait is felt to be the equivalent of the "next vital sign," as it predicts health care utilization, hospitalization and poor outcomes particularly when the gait speed is slow and declining. Part of our project is also to develop the capabilities to measure gait speed in the home environment.
We will study how well the relatively new FDA approved pneumonia vaccine can protect older renal transplant recipients against pneumococcal illness. We will specifically study the group of renal transplants in whom the cause of renal failure was either diabetes mellitus II and/or hyoertension. We will compare the findings against those we find in younger renal transplant recipients, older healthy individuals and older persons with diabetes but normal kidney function. Healthy younger individuals will serve as controls for optimal vaccine response.
This research studies the effects of brain stimulation (transcranial magnetic stimulation, or "TMS") on balance in progressive supranuclear palsy (PSP). The purpose of this research is to look for improvements in balance when subjects are on a tilting platform after stimulating the brain with a magnetic wand held over the scalp over an area at the back of the brain called the cerebellum. Participants will receive both active and inactive stimulation during the course of the study. There is no surgery involved. There are also optional portions of the study that include functional magnetic resonance imaging (fMRIs) and speaking samples.