Answer

Hamm, J., Money, A. G., Atwal, A., & Paraskevopoulos, I. (2016). Methodological Review: Fall prevention intervention technologies: A conceptual framework and survey of the state of the art. Journal Of Biomedical Informatics, 59319-345. doi:10.1016/j.jbi.2015.12.013

            Hamm et al (2016) argue that despite the growing information and innovations in the utilization and development of assistive technologies among hospitalized elderly patients, there is inadequate information on the risk factors associated to fall and thus inadequate information regarding better intervention technologies that could be adopted. Furthermore, the authors says that existing post fall intervention technologies limit the interaction between patients and the practitioners taking care of them. Accordingly, the researchers apply a methodological review that involves the collection of data and interpretation based on a conceptual framework approach. It is also important to note the researchers limit the scope of their research to the current state of intervention technologies used to prevent falls in hospitals. This leads to four analytical categories for the research; pre-fall and post fall prevention, cross-fall prevention and  fall injury prevention.

            Furthermore, the researchers were able to develop other categories like the application type, collaborative function devices, deployment environment, information sources systems, technology deployment platforms and the user-interface types. In this regard, the study realized that there are numerous challenges that affect the deployment of effective intervention technologies and therefore some of the solutions to these challenges include: an introduction of new systems that specifically help to detect extrinsic fall risk factors, introduction of systems that can carefully asses the environment and potential risk of falling, development of a system that allows better collaboration between patients and practitioners and lastly, utilization of a collaborative approach to the risk assessment, prevention and intervention activities. This study seems to give a general view towards the application of assistive technologies towards preventing falls and fails to mention the technologies used for safe mobility as mobility also increases chances of falling. Nonetheless, the study effectively contributes to the proposed research by emphasizing the role of assistive technology towards improving the care provided to hospitalized elderly patients.

Schultz, J. S., André, B., & Sjøvold, E. (2015). Demystifying eldercare: Managing and innovating from a public-entity’s perspective. International Journal Of Healthcare Management, 8(1), 42-57. doi:10.1179/2047971914Y.0000000097

                This study by Schultz, Andre and Sjovold (2015) is perhaps one of the most comprehensive yet challenging interventions ever developed towards encouraging innovations in the healthcare sector towards demystifying elderly care. Basically, this study adopts numerous interventions for improved elderly care based on the public’s perspective towards various technologies and interventions. In this regard, amidst the complexities of the proposed systems and the nature of application of the technologies, the systematic reviews provided provide adequate research interventions that can be queried against each other to identify the most appropriate technologies for different environments and workplaces. Accordingly, the utilization of assistive technology is clearly discussed as part of the interventions towards improving independent care at home, care centers and in hospitals.

            The authors also state that there are numerous advantages in the utilization of mobility assistive technologies just like in any other form of assistive system. Specifically, movement assistive technologies in hospitals have been able to detect and notify in case of risks, these systems have been able to facilitate mobility increasing the chances of exercises thus contributing to better health through fitness, they have also reduced the number of falls as the hospitalized elderly patients have been able to receive different forms of support, these systems have also contributed to increased interactions between patients and their caregivers in hospitals and other centers and lastly, they have reduced the cost of hospitalization by promoting faster recovery. The only shortcoming with this study is the provision of numerous generalized innovative approaches that can be costly and in some cases, impossible to implement within all hospitals. Despite this, it provides adequate innovative technologies that can be applied to increase the mobility of hospitalized elderly patients.

Tung, J. Y., Stead, B., Mann, W., Pham, B., & Popovic, M. R. (2015). Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review. Journal Of Rehabilitation Research & Development, 52(2), 131-145. doi:10.1682/JRRD.2014.02.0064

            In this study, Tung et al (2015) acknowledge that new technologies are important towards ensuring self-managed care and prevention of pressure ulcers among patients with spinal cord injuries (SCI). The study therefore reviews four specific technologies believed to have the ability to prevent the occurrence of pressure ulcer in SCI patients. As a scoping review, the research developed information from secondary sources based on literature available through acceptable scientific websites like PubMed and majored its reviews on researches between 1979 and 2012. In order to interpret the various findings by the researchers, the authors used a qualitative thematic analysis in which conceptual framework was used to identify the physiological factors that lead to PU development and behavioral models to illustrate to technology developers how contextual factors contribute to self-management practices.

            Accordingly, Tung and his colleagues found out that there are for key factors that greatly determine the ability of a SCI patient to independently manage their health towards the prevention of the occurrence of PU. First is the pressure applied on the tissues and shear as an outcome of pressure on the tissue, second is the tissue tolerance or resistance to damage, third is physical functioning of the body and the ability to sense the risk of PU especially through pain and lastly, lifestyle factors that influence the ability to protect against the occurrence of the condition. The others suggest that these cases can therefore be effectively handled by the utilization of assistive technologies like: educational technologies that led to improved outcomes in the short term, pressure mapping technologies that led to adherence to pressure reliefs, electrical simulations led to better tissue tolerance and increased self-management through the use of telemedicine. Although this research does not emphasize its applications among hospitalized patients, it reiterates the relevance of assistive technologies and even features interventions that can be applied in a hospital setting.

Winkler, S. H., Wu, S., Ripley, D. C., Groer, S., & Hoenig, H. (2011). Medical utilization and cost outcomes for poststroke veterans who receive assistive technology devices from the Veterans Health Administration. Journal Of Rehabilitation Research & Development, 48(2), 125-133. doi:10.1682/JRRD.2010.05.0081

            Winkler et al (2011) sought to study and understand the relationship between the utilization of assistive technology devices (ATDs) and the need for continued healthcare services based on the outcomes of utilizing ATDs both at home or among hospitalized patients. On the other hand, these researchers also focused on explaining the relationship between the provision of ATDs and their utilization among inpatient/outpatient and cost effects for the services among post stroke patients. The overall objective was to address various ways of ensuring equal and fair access to ATDs by post stroke patients. The study therefore adopted a covariant analysis featuring bivariate and multivariate analyses among patients at 65years or over but receiving post stroke treatment. Provision of ATDs was considered the independent variable whereas inpatient days, outpatient visits and VA costs were the dependent variables.

            This research was able to establish that the motor based ATDs were mainly provided to inpatient while outpatients were provided with scooter ATDs towards facilitating mobility. On the other hand, veterans who received motor gain ATDs only required rehabilitation for 11 days while those who did not receive ATDs receive ATDs or ordinary wheelchairs received rehabilitation for up to 18 days. In summary, the study predicts that the provision of ATDs to post stroke veterans leads to better outcomes especially for hospitalized patients. In contrast, the authors feel that the time taken in rehabilitating the patients while utilizing the ATDs is still relatively long and therefore better ATDs have to be developed to improve the outcomes. The study also acknowledges that administrative data used may not be accurate and therefore this may undermine the results obtained. It is however clear that the application of ATDs for hospitalized patients contributes to faster recovery thus should be encouraged but better outcomes would only be attained through the use of innovative ATDs.