Evidence-based practice

BACKGROUND: In older adults, diminished balance is associated with reduced physical functioning and an increased risk of falling. This is an update of a Cochrane review first published in 2007.
OBJECTIVES: To examine the effects of exercise interventions on balance in older people, aged 60 and over, living in the community or in institutional care.
SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE and EMBASE (to February 2011).
SELECTION CRITERIA: Randomised controlled studies testing the effects of exercise interventions on balance in older people. The primary outcomes of the review were clinical measures of balance.

ARE HOSPITAL FUNDING MECHANISMS IN CANADA DESIGNED TO PROVIDE EFFICIENT CARE?
Canadian governments are spending more on healthcare than ever. Driven by technological innovation, population aging, inflation and other factors, public healthcare expenditures are forecast to continue to increase, causing concern about the sustainability of Canada’s publicly funded systems. The hospital sector accounts for over 28% of total healthcare expenditures in Canada. Although this share has fallen considerably over the past few decades, hospitals continue to represent the largest single component of healthcare expenditures. Hospital expenditures are
projected to exceed $55 billion in 2010. 

The IHI Improvement Map

The Improvement Map is a free interactive, web-based tool designed to bring together the best knowledge available on the key process improvements that lead to exceptional patient care.
 

Helping nurses assess and manage pain in older adults
Free evidence-based tools and best practices for nurses who work in nursing homes.

Pain is under-recognized and undertreated in older persons, particularly those who reside in the nursing home. In long-term care settings, the prevalence of pain can be as high as 85% and impacts the quality of life of this vulnerable population. Pain is a common condition and deserves to be recognized and effectively treated. Clinical practice guidelines are available from the American Geriatric Society (AGS) and the American Medical Directors Association (AMDA) to guide clinical decision-making related to assessment and management of pain in older adults. However, barriers, misconceptions and knowledge gaps impact good pain care.