Introdução: As lesões de pele representam um grande desafio para os profissionais de saúde que prestam cuidados a pacientes críticos, especialmente os com alterações cardiopneumológicas, pois é frequente ocorrências de úlceras por pressão e de lesões por fricção nessa clientela com aumento de custos no tratamento e do tempo de internação além de desconforto e impacto negativo sobre a qualidade do serviço prestado e de vida dos pacientes. Objetivos: Este estudo objetivou identificar e analisar os coeficientes de incidência de úlceras por pressão e lesões por fricção e os fatores de risco para o seu desenvolvimento em pacientes de Unidade de Terapia Intensiva (UTI) Cardiopneumológica. Métodos: Trata-se de um estudo de coorte, prospectivo, cuja coleta de dados ocorreu durante os meses de novembro de 2013 a fevereiro de 2014, com censura de uma semana. O estudo foi realizado em uma UTI destinado a pacientes com doenças cardíacas e pulmonares de um hospital de grande porte na cidade de São Paulo, após aprovação dos Comitês de Ética em Pesquisa (CEP) da Escola de Enfermagem da Universidade de São Paulo e da instituição, de acordo com protocolo número 20780713.4.0000.5392, com parecer consubstanciado publicado na Plataforma Brasil em 24/10/2013. Participaram da amostra 370 pacientes maiores de 18 anos, que não apresentavam úlceras por pressão e lesões por fricção na admissão, que aceitaram participar do estudo (assinando o Termo de Consentimento Livre e Esclarecido) e que estavam na unidade há menos de 24 horas. Para análise dos dados foram utilizadas análises univariadas e a Classification And Regression Tree (CART). Resultados: Incidências globais de 10,80%, 7,02% e 2,16%, respectivamente para úlceras por pressão, lesões por fricção e ambas as lesões simultaneamente foram encontradas nos pacientes críticos. Diferentes fatores de risco foram encontrados, conforme o tipo de lesão, sendo o tempo de permanência na UTI igual ou superior a 9,5 dias e idade igual ou superior a 42,5 anos comuns para as úlceras por pressão e lesões simultâneas. Além desses, raça branca; uso de superfícies de suporte e número de artefatos invasivos na admissão; e uso de transfusão sanguínea foram fatores constatados respectivamente para as úlceras por pressão, lesões por fricção e lesões simultâneas Conclusão: Os coeficientes de incidência e os fatores de risco constatados assemelham-se a alguns estudos da literatura, somente para as úlceras por pressão. Para as lesões por fricção e lesões simultâneas, não foram encontrados estudos desenvolvidos junto a pacientes críticos, sendo, no entanto, corroborados alguns dos fatores de risco descritos em grupos e cenários distintos como idosos residentes em instituições de longa permanência e pacientes crônicos hospitalizados. O estudo contribui, portanto, para os conhecimentos relacionados à epidemiologia dessas lesões, recomendando-se a replicação de seus métodos, principalmente para as lesões por fricção em pacientes hospitalizados, isoladamente ou em associação com as úlceras por pressão. Por outro lado, ao favorecerem a maior compreensão do panorama dessas lesões em pacientes cardiopneumológicos críticos, os resultados obtidos poderão favorecer o planejamento de cuidados preventivos específicos para essa clientela / Introduction: Skin lesions represent a major challenge for health professionals who care for critical patients cardiopneumologics. In clinical practice, have been frequent occurrences of pressure ulcers and skin tears, by rubbing with increased costs in treatment, prolonged hospitalization, in addition to discomfort and negative impact on the quality of service and the quality of life of patients.Goal: This study aimed to identify and analyze the rate of incidence of pressure ulcers and skin tears and the risk factors for its development in patients in the Intensive Care Unit(ICU) Cardiopneumologic. Methods: This study is a prospective cohort which data collection occurred during the months of November 2013 to February 2014, with censorship of a week. The study was conducted in a Surgical Intensive Care Unit Cardiopneumologic of a large hospital in the city of São Paulo, after approval of the Ethics Committee (EC) of the School of Nursing, University of São Paulo and the institution in accordance with protocol number 20780713.4.0000.5392 with sound embodied the EC Platform published in Brazil on 10/24/2013. A sample of 370 patients older than 18 years who did not have any injuries mentioned (pressure ulcers and skin tears) on admission, and who agreed to participate (by signing the Instrument of Consent) and who were in the unit for less than 24 hours. For data analysis were used univariate analyzes and the Classification And Regression Tree (CART). Results: overall incidences of 10.80%, 7,02% and 2.16% respectively for pressure ulcers, skin tears and both lesions simultaneously were found in critically ill patients. Different risk factors were found, depending on the type of injury, and length of stay in ICU less than 9,5 days old and less than 42,5 years common for pressure ulcers and concurrent injuries. Besides these, the white race; Use of support surfaces and the number of invasive devices in entry; and use of blood transfusion were observed factors respectively for pressure ulcers, skin tears and simultaneous injuries Conclusion: The incidence and risk factors observed are similar to some studies in the literature, only for pressure ulcers. For skin tears and simultaneous lesions, no studies have not found together developed the critical patients, however, corroborated some of the risk factors described in groups and different scenarios as seniors residents in long-term hospitalized chronic patients and institutions. The study therefore contributes to the knowledge regarding the epidemiology of these types of injuries, recommending that replication of their methods, especially for lesions friction in acute inpatients and critics, alone or in combination with pressure ulcers. On the other hand, by favoring a greater understanding of these lesions panorama critical cardiopneumologics patients, the results will may facilitate the planning of specific preventive care for these clients

Antimicrobial resistance is a significant global health problem. Misuse of antibiotics is associated with antimicrobial resistance which presents clinicians with treatment challenges and increases the complexity of the decision making process related to the selection of appropriate antibiotic therapy. Antibiotic resistant organisms can often lead to nosocomial infections (NIs) and undoubtedly causes patient harm and increases healthcare costs. According to the National Institute of Allergy and Infectious Diseases (NIAID), at least 70% of the nosocomial infections are caused by antibiotic-resistant organisms. In addition to the problem of inappropriate prescribing, the decreased production of antimicrobial agents over the past 25 years has restricted the arsenal of available antimicrobial agents. The combination of inappropriate antibiotic prescribing practices and reduced research and development of new antimicrobial agents have promoted concerns that society may soon return to a pre-antibiotic era. Addressing the attitudes and behaviours that contribute to inappropriate antibiotic prescribing is a potentially effective and immediate solution to the growing antimicrobial resistance problem. Modifying clinicians' prescribing behaviour with antibiotic decision guidelines and highlighting the problematic side of this issue can promote judicious antibiotic prescribing practices. Representing the existing data regarding the use and misuse of antimicrobials in a Lebanese hospital can support and encourage initiating and complying with antibiotic stewardship programs and prescription guidelines. Purpose: The objectives of this study were to determine current levels and trends in prescribing antibiotics to patients in a Lebanese hospital, (2) to identify the factors that physicians considered when deciding to start antibiotics, (3) to explore whether antimicrobial use (empiric, prophylactic, targeted) will change when physicians fill out a form to document why they prescribed antibiotics, (4) to explore whether an increase in bacterial resistance occurs when antimicrobial consumption increases, (5) to explore the clinicians' perception towards antimicrobial use and antimicrobial stewardship program pre- and post- implementation of an antibiotic assessment form, (6) to explore the effect of the implemented antimicrobial stewardship intervention combined with hand hygiene (HH) on healthcare associated infection rate (HAIs) in the hospital. One-year retrospective study in a Lebanese hospital was conducted to determine the percentage of patients who received antimicrobial treatment and to identify the inappropriateness of their use in different hospital departments. A 12-months intervention was then implemented during which all attending physicians were asked to fill an antimicrobial assessment form (AAF) to document their rationale for starting antimicrobial therapy. In addition, this AAF was used to identify factors physicians considered when deciding to prescribe antimicrobials. Data from the AAFs suggested that physicians in the hospital often considered elevated C-reactive protein, elevated white blood cell counts, and elevated temperatures when deciding to start antimicrobial therapy. Data showed that antibiotic consumption and the median duration of empiric and targeted therapies decreased significantly during the intervention period when compared to the pre-intervention period. Antibiotic appropriateness was also increased significantly after the intervention was conducted. In addition, a better understanding of antimicrobial stewardship strategies was also noted by physicians after the implementation of the intervention. On the basis of these results, AAF filling was a successful intervention to reduce antibiotic use and to urge physicians to refer to antibiotic guidelines when initiating an antimicrobial agent. However, additional measures such as automatic stop orders and computer decision support may be easier and useful for reducing the duration of therapy in hospitals.

Magister Curationis - MCur / Unlawful absence of patients from the acute psychiatric ward increases concern on the part of the professionals responsible for their care. Patients who abscond from psychiatric hospitals represent a risk of potential harm to patients or the general public. Consequences of absconding may include physical harm and prolonged treatment time, as well as considerable economic cost to the family and government. The aim of the study was to explore and describe the nurse's experiences of assessment and management for patients at risk of absconding from an acute psychiatric ward in the Western Cape. A qualitative approach using an exploratory descriptive design was applied to conduct this study. The target population was mental health nurses working in acute psychiatric wards where patients were at risk of absconding. A sample of ten (n=10) mental health nurses was purposively selected to participate in the study. Semistructured interviews were used to collect the data from participants. Data collection continued until data saturation was reached (until no further new information emerged). Data was analysed manually by coding, categorizing and identifying similar patterns. Trustworthiness of the study was ensured through addressing the confirmability, transferability; credibility and dependability. Ethics approval was obtained from the University Research Ethics Committee and Ethics Committee of the Department of Health and the selected psychiatric hospital. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent were adhered to. Three themes emerged from the data: risk assessment, risk management, and increased observations. The results of the study was discussed with relevant recent literature evidence. The qualitative research is limited to few study sample size, and the results cannot be generalized to other similar population.

Bakgrund: Inom psykiatrisk vård är det viktigt att respektera patientens personliga förväntningar och mål för att uppnå goda behandlingsresultat och för att patienterna ska känna sig tillfreds med den vård de erhåller. Sjuksköterskan bör underlätta för patienter att kommunicera om sina besvär, stödja patienten att analysera destruktivt beteende, stödja patienten att skapa en normal daglig livsföring samt främja patientens integritet och egenvård. Trots detta upplever inte patienterna att detta uppfylls alla gånger. Syfte: Syftet med denna litteraturöversikt var att undersöka patienter med psykisk ohälsa med fokus på deras upplevelser av vården på psykiatriska vårdavdelningar.  Metod: I denna litteraturöversikt har författarna använt tio vetenskapliga artiklar för att besvara syftet. Dessa har granskats för att förstå skillnader och likheter och sedan delats in i teman. Resultat: Tre teman och tre underteman påvisades i denna litteraturöversikt. Ett tema var patienters upplevelser av att bli eller inte bli behandlad med respekt med undertemana patienters upplevelser av stigmatisering samt patienters upplevelser av vårdande miljö. Det andra temat var upplevelser av personalens förhållningssätt med undertemat patienters upplevelser av vårdande relationer. Det tredje och sista temat var patienters upplevelser av trygghet. Diskussion: I diskussionen diskuterar författarna patienters upplevelser på psykiatriska vårdavdelningar samt hur dessa påverkar dem. Författarna kom fram till fyra områden; patienters upplevelser av maktlöshet vid stigmatisering, vårdandets och miljöns påverkan på känslor av trygghet, självbestämmandets betydelse samt betydelsen av delaktighet. Dessa områden diskuterades och jämfördes med befintlig forskning och knöts an till Phil Barkers tidvattenmodell. / Background: In psychiatric care, it is important to respect the patients’ personal expectations and goals in order to achieve good treatment outcomes and to make patients feel satisfied with the care. The nurse should help patients to communicate about their inconveniences, support the patient to analyze destructive behaviors, support the patient to create a normal daily life routine and promote patients’ integrity and self-care. However, patients do not experience this in psychiatric care. Aim: The aim of this literature review was to explore patients with mental illness focusing on their experiences of care in psychiatric care units. Method: In this literature review the authors used ten scientific papers to answer the aim of the review. These articles have been examined to understand differences and similarities and then the authors performed a thematic analysis. Results: Three themes and three subthemes were identified in this literature review. The first theme was patients’ experiences of being or not being treated with respect with the associated subthemes patients’ experiences of stigmatization and patients’ experiences of the health care environment. The second theme was the experience of the staff's attitude with the associated subtheme patients’ experiences of caring relationship. The third and last theme was patients’ experiences of safety. Discussion: The authors discussed patients' experiences in psychiatric care units and how these experiences affect the patients. The discussion emphasized four areas; patients experiences of powerlessness in stigmatization, the healthcare’s and the environment's impact on feelings of safety, the importance of self-determination and the importance of participation. These areas were discussed and compared to existing research and also linked to Phil Barker's tidal model.

O papel desempenhado pelos recursos humanos na produção de serviços de saúde e, particularmente, no campo da enfermagem merece atenção especial. Este estudo aborda a temática da gerência de recursos humanos tomando por referência a questão do dimensionamento de pessoal de enfermagem em um setor específico de atuação: o hospital. Trata-se de uma investigação na modalidade de estudo de caso cujo objetivo geral é dimensionar o quadro de pessoal de enfermagem para unidades de internação de um hospital universitário situado em um município do oeste do estado do Paraná. A metodologia adotada é aquela proposta por Gaidzinski (1998) que contempla a identificação de determinadas variáveis, às quais correspondem instrumentos específicos de coleta de dados. Para identificação do grau de dependência do paciente em relação ao cuidado de enfermagem, utilizou-se o Sistema de Classificação de Pacientes segundo Perroca (2000); para as horas médias de assistência de enfermagem e o percentual de cada categoria profissional adotou-se como parâmetro a Resolução COFEN nº 189/96; a definição do índice de absenteísmo bem como a equação para cálculo do quadro de pessoal foram desenvolvidas segundo a metodologia preconizada por Gaidzinski (1998). As unidades de internação estudadas foram aquelas em que a clientela atendida era composta por adultos (≥ 14 anos), nas especialidades de clínica médica e clínica cirúrgica. Do total de 62 leitos ativados nas três unidades de internação estudadas, foram classificados, diariamente durante 92 dias consecutivos, 72,5% dos leitos que correspondem a 4.135 pacientes/dia. Para os demais 27,5% dos leitos, a classificação não se efetivou devido à recusa do paciente em participar do estudo e outras ocorrências. Dos pacientes classificados, 9,4% requeriam cuidados intensivos, 14,6% cuidados semi-intensivos, 45,1% cuidados intermediários e 30,9% cuidados mínimos. Para as ausências previstas, o maior índice deve-se às folgas semanais, para as ausências não previstas o índice mais elevado ocorre devido às licenças médicas. Aplicando-se a equação de dimensionamento, obteve-se um quadro projetado de 28 enfermeiros e 48 auxiliares de enfermagem. Comparando-se o quadro existente com o projetado verifica-se que para a categoria enfermeiro, o quantitativo existente corresponde a 50% daquele previsto; para a categoria de auxiliares de enfermagem há um excedente de 29,2%. Diante do quadro reduzido de enfermeiros, levanta-se a hipótese de que determinadas ações de enfermagem inerentes a esse profissional estejam sendo desenvolvidas pelo pessoal de nível médio, sem um processo de supervisão que permita o desenvolvimento de um trabalho mais articulado e integrativo, resultando em uma assistência de enfermagem de melhor qualidade. Entende-se, ainda, que a adoção, pelos enfermeiros, de um sistema de classificação de pacientes em suas respectivas unidades, permitirá ampliar o conhecimento acerca da clientela atendida, suas reais necessidades, bem como o desenvolvimento de habilidades e competências que lhe assegurem assistir e gerenciar de um modo mais seguro, inovador, autônomo e participativo. / and particularly in the Nursing field, deserves special attention. This study approaches human resources management based on the dimensioning of nursing personnel in a specific sector of activity: the hospital. It is a case study whose goal is to dimension the nursing personnel for inpatient units at a university hospital located in a city of western Paraná state. The methodology adopted is that proposed by Gaidzinski (1998), as it contemplates the identification of certain variables to which specific data collection instruments correspond. In order to identify patients’ dependence in relation to nursing care, the Patient Classification System was used according to Perroca (2000); concerning the mean hours of nursing care and the percentage of each professional category, Resolution COFEN no. 189/96 was adopted as a parameter; the definition of absence rates as well as the equation used to calculate the staff were developed according to the methodology proposed by Gaidzinski (1998). The inpatient units under study were those in which the clients assisted consisted of adults (≥ 14 years old) in the specialties of medical clinic and surgical clinic. Of the total number of 62 activated beds in the three inpatient units under study, 72.5% of the beds were classified daily during a period of 92 consecutive days, which corresponds to 4.135 patients/day. As to the remaining 27.5% beds, classification was not conducted due to patients’ refusal to participate in the study and to other occurrences. Of the classified patients, 9.4% required intensive care, 14.6% semi-intensive care, 45.1% intermediate care and 30.9% minimum care. Concerning predicted absences, the highest rate was due to weekly work pauses whereas for non-predicted absences, the highest rate occurred as a result of sick leaves. The application of the dimensioning equation resulted in a staff consisting of 28 nurses and 48 nursing auxiliaries. By comparing the existing staff and the projected staff, it was observed that the number of working nurses corresponded to 50% of the predicted number whereas, in relation to nursing auxiliaries, there was an excess of 29.2%. In view of the reduced number of nurses, a hypothesis was made that certain nursing actions which are inherent to that professional category are being performed by nursing auxiliaries without a supervision process that would allow for the development of more articulated and integrative work, which would, in turn, result in better quality nursing care. It is also understood that the adoption, by nurses, of a patient classification system in their respective units will bring further knowledge concerning the clients assisted, their real needs as well as the development of skills and competencies that will enable them to provide care and manage their work in a more safe, innovative, autonomous and participant fashion.

Background: The prevalence of mental illness is increasing and so is the need for psychiatric care. The relationship to the staff affects the well-being and recovery of the patient. Many patients who are living with mental illness experience unfair treatment during psychiatric care.   Aim: This study aimed to describe patient’s experiences of being cared for in a closed psychiatric ward.   Method: A literature review based on 13 qualitative interview studies. The analytic process consisted of coding and thematization.   Results: Four themes covering the patient’s experiences were identified: Meaningful relationships, the importance of activities, being well-informed, to have or not have control.   Conclusion: Patient report that the relationship to the staff affects their well-being and recovery. Being treated with respect promotes a safe and trustful relationship, which enables them to open up and talk about their problems. This in turn makes it possible for staff to identify their problems and help solving them. Factors that promote a safe and trusting relationship is individualized care, where the information is sufficient and understandable for the patient. This enables patients to participate in their care.

Introduction: The dietary intake of the elderly, especially the protein intake, is very important as to avoid any complications and for the proper course of hospitalization. Prerequisite for this thesis is that within the general ward we can mostly find elderly patients, therefore, this thesis is focused also on the topic of malnutrition. Malnutrition is very closely connected to the elderly and generally to the dietary intake during hospitalization. Aim: The main aim of this thesis is to outline and review the actual amount of consumed energy and protein of elderly patients in hospitals. The amount is determined by an analysis of returned food and is compared to the recommended intake of energy and protein for individual patients. The objective is also to evaluate possible reasons for the low food intake concerning certain patients. Methods: The energy and protein intake were assessed by the analysis of patient's returned food and then calculated in the nutritional application Nutriservis. The potential reasons for the low food intake concerning the elderly patients were assessed by surveys using frequential, closed-ended questions. A part of the survey was focused on the diet during the stay in the hospital, the other part was inspired by the scale of MNA screening and it was aimed at the BMI...

Bakgrund: Sömn är ett naturligt behov alla människor måste underkasta sig. Patienter upplever ofta att sömnen påverkas under en sjukhusvistelse. Frånvaro avsömn eller störd sömn påverkar patienter fysiologiskt och psykologiskt. Patienter som vårdas på sjukhus upplever en rad olika faktorer som påverkar sömnen negativt liksom positivt. Det är nödvändigt för sjuksköterskor att ha kännedom om vad inneliggande patienter upplever påverkar sömnen och betydelsen av en god sömn. Syfte: Syftet med litteraturstudien var att sammanställa sjuksköterskors erfarenheter av omvårdnad kring sömn för patienter inom slutenvården. Metod:Litteraturstudie med kvalitativ ansats. Sökningar av vetenskapliga artiklar gjordesi Cinahl och PubMed, varav tio valdes ut som svarade mot syftet. De tio vetenskapliga artiklarna granskades enligt SBU:s granskningsmall för kvalitativa studier och analyserades sedan med stöd av Graneheim och Lundmans modell för innehållsanalys. Resultat: Ur analysen framkom tre kategorier. Kunskapsluckorkring sömn, som en del av omvårdnad, framkom som en första kategori. Andra kategorin som sjuksköterskans ambition i konflikt med organisationens förutsättningar. Tredje kategorin som framkom var, förmåga att främja sömn hos inneliggande patienter, varpå denna kategori kunde delades in ytterligare i två subkategorier. Följsamhet till patientens behov och känslor liksom Miljöanpassningar för att optimera patienters sömn. Konklusion: Trots att sömnenär en faktor för patientens tillfrisknande ges sömnen lite utrymme i omvårdnadsarbetet med inneliggande patienter. Enligt sjuksköterskor beror dettafrämst på bristfällig evidensbaserad kunskap, snarare är kunskap inhämtad från sjuksköterskors egna erfarenheter. För att kunna värna om patienters sömn är dettill fördel för sjuksköterskor att ha kännedom om vilka konkreta omvårdnadsåtgärder som kan utföras. Vara följsam till patienterna och en medvetenhet att kunna justera sjukhusmiljön. / Background: Sleep is a natural need to which all people must submit. Patients often experience that sleep is restricted during hospitalization. Absence of and disturbance of sleep affects patients physiologically and psychologically. Patients who are cared for in hospitals have several negative as well as positive experiences affecting their sleep. It is necessary for nurses to have knowledge of what affects their patients sleep and how important it is for them. Purpose: The purpose of the literature review was to compile nurses' experiences regarding nursing care for patients in inpatient care. Method: This is a literature review with a qualitative approach. Searches for scientific articles were made in the databases Cinahl and PubMed. From these databases ten studies were selected that corresponded to the purpose of the literature study. The selected scientific articles were reviewed according to SBU's review template for qualitative studies and was then analysed using the model of Graneheim and Lundman. Results: The analysis revealed three categories. Knowledge gaps around sleep, as part of nursing, emerged as a first category. The second category as the nurse's ambition inconflict with the organization's conditions. The third category that emerged was the ability to promote sleep in inpatients, after which this category could be further divided into two subcategories. Compliance with the patient's needs and feelings as well as Environmental adaptations to optimize patients' sleep. Conclusion: Although sleep is a factor in the patient's recovery, sleep is given little space in the nursing work for inpatients. According to nurses, this is mainly due to a lack of evidence-based knowledge, rather knowledge is obtained from nurses' own experiences. In order to be able to safeguard patients' sleep, it is to the advantage of nurses to have knowledge of what concrete nursing measures can be performed. Be compliant with patients and an awareness of being able to adjust the hospital environment.

Bakgrund: Fall och fallskador hör till ett av de stora folkhälsoproblemen i Sverige men även internationellt. Fall är den vanligaste orsaken till skador hos äldre personer över 65 år och resulterar ofta i allvarliga konsekvenser för samhället, vården och individen.  Syfte: Att kartlägga fallpreventiva insatser beskrivna i internationell vetenskaplig litteratur avseende äldre (65+) patienter inom slutenvård samt att studera effekten av dessa insatser. Metod: Litteraturöversikt där 17 vetenskapliga kvantitativa artiklar granskades. Resultat: Resultat från denna litteraturöversikt visade att fallriskbedömning var en vanligt förekommande del i det fallpreventiva arbetet internationellt och en förutsättning för individuella fallpreventiva insatser inom slutenvård. I fallriskbedömningen betonades vikten av att inkludera riskfaktorer förknippade med fall som främst var hög ålder och lång vårdtid. De fallpreventiva insatser som identifierades kategoriserades in i fyra huvudsakliga områden; utbildning, övervakning/tillsyn, fysisk träning och vårdmiljö. Slutligen framkom i resultaten att multifaktoriell fallprevention och sjuksköterskeledda timsrundor (IR) hade effekt på minskning av fall. Slutsats: Få studier undersökte effekten av fallpreventiva insatser, därför behövs ytterligare studier göras på området för att resultaten ska vara generaliserbara. Utbildning och ökad tillsyn eller personaltäthet visade sig sannolikt vara faktorer med betydelse för minskning av fall, detta kan vara av intresse för framtida forskning. / Background: Falls and fall related injuries are one of the major public health issues in Sweden as well as internationally. Falls are the most common cause of injury in older people over the age of 65 and often result in serious consequences for society, healthcare and the individual. Aim: To identify preventive measures for falls described in international scientific literature regarding elderly (65+) inpatients and to study the effects of these measures.  Method: Literature review of 17 quantitative assessed scientific articles.       Results: Results from this literature review showed that fall risk assessment was a common part of the fall prevention strategy internationally and a prerequisite for individual fall preventative measures in care settings. The fall risk assessment emphasized the importance of including risk factors associated with falls which were old age and long hospital stay. The fall preventions interventions identified were categorized into four main areas; education, monitoring/supervision, physical training and hospital environment. Finally the results showed that multifactorial fall prevention and intentional rounding (IR) had an effect on reducing falls.  Conclusion: Few studies examined the effect of fall prevention measures, further studies are therefore needed for the results to be generalizable. Education and increased monitoring/supervision were probably found to be factors with significance for reducing in falls, this may be of interest in upcoming research.

Offenders and persons with serious mental illness experience disproportionate exposure to Adverse Childhood Experiences (ACEs). This study examines prevalence, distribution, and correlates of ACEs in 182 male and female forensic psychiatric inpatients in secure care. Descriptive statistics, chi-squares analysis, ANOVA, and logistic regression were used to describe ACEs by race and gender and to identify associations between ACEs and onset of aggression, arrest, and psychiatric hospitalization. Participants evidenced significant exposure to ACEs, with significant differences by race and gender. ACE score, race, and foster care or investigations of child abuse were significant predictors of outcomes related to aggression and criminality.