Tecnologia educativa para prevenção de quedas em pessoas idosas institucionalizadas : ferramenta para gestão do cuidado em enfermagem

Abstract

Introduction: The institutionalization of elderly people represents a risk factor for falls, as the abrupt change from the family environment to an unfamiliar environment can cause cognitive, psychological and even functional changes. Objective: To develop an educational technology on preventing falls in institutionalized elderly people, based on the adaptive modes of Callista Roy's Adaptive Theory for the ongoing education of the Nursing team. Method: Methodological study, carried out between February 2023 and January 2024 using a quantitative-qualitative approach in three stages: integrative literature review, analysis of Callista Roy's Adaptive Theory and situational diagnosis. In the integrative review, following a hierarchical model, evidence was sought on fall prevention in institutionalized elderly people. The analysis of Roy's theory, according to the Meleis method, examined its applicability in nursing. The situational diagnosis, carried out with nursing teams from two Long-Term Institutions for the Elderly, used the Focus Group technique to understand perceptions and needs regarding fall prevention. The data were analyzed using Bardin's content analysis technique, supporting the construction of the process flowchart on fall prevention for institutionalized elderly people. The study was approved by the Research Ethics Committee under opinion no. 5,982,356. Results: Exercise programs, continuous assessments of functional and cognitive capacity, careful review of medication, and improvements in the conditions of the institutions' physical environment were interventions identified in the literature review. Through situational diagnosis, it was possible to list with the nursing teams the risk factors for accidents due to falls, such as bodily weaknesses, the use of medication and challenges in the environmental infrastructure that affect the adaptation of the elderly, in line with the emphasis of the theory of Roy in the environment as a stressor. A process flowchart was created with the aim of assisting nursing teams in providing guidance on preventing falls within the service, whether for newly hired professionals, family members and even elderly residents. Conclusion: The data and discussions highlight the urgency of reviewing fall prevention practices in Long-Term Care Institutions for the Elderly, due to the excessive use of physical restraint by nursing professionals. A comprehensive, evidence-based, older person-centered approach is recommended, including risk assessment, physical activity, medication review, environmental adjustments, and education. Investments in training are essential to improve the quality of care offered, highlighting the fundamental role of nursing in this process.