Identification and team-based interprofessional management of hospitalized vulnerable older adults

Nursing Outlook
Jeff Edward BorensteinGlenn David Braunstein

Abstract

Extended hospital stays and complications are common among older adults and may lead to morbidity and loss of independence. Specialized geriatric units have been shown to improve outcomes but, with the growing numbers of older adults, may be difficult to scale to meet needs. The purpose was to evaluate a quality improvement initiative that redesigned unit-based workflow and trained interprofessional teams on general medical/surgical units to create care plans for vulnerable older adults using principles of comprehensive geriatric assessment and team management. The evaluation included a cluster randomized controlled trial of 10 medical/surgical units and intention-to-treat analysis of all patients meeting risk screening criteria. N = 1,384, median age = 80.9 years, and 53.5% female. Mean difference in observed vs. expected length of stay was 1.03 days shorter (p = .006); incidence of complications (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.21-0.98) and transfer to intensive care (OR = 0.45; 95% CI = 0.25-0.79) lower among patients admitted to intervention units; incidence of discharge to institutional care was higher (OR = 1.43; 95% CI = 1.06-1.93). Mortality during hospitalization (OR = 0.64; 95% CI = 0.37-1.11)...Continue Reading

References

Dec 15, 1990·Annals of Internal Medicine·S K InouyeR I Horwitz
Mar 27, 2003·Journal of the American Geriatrics Society·Kenneth E CovinskyC Seth Landefeld
Oct 9, 2003·JAMA : the Journal of the American Medical Association·Chunliu Zhan, Marlene R Miller
Mar 17, 2006·The New England Journal of Medicine·Sharon K Inouye
Jun 9, 2006·The New England Journal of Medicine·Enrique Anton, Juan Marti
Sep 27, 2007·The American Journal of Nursing·Terry Fulmer
Oct 22, 2008·Critical Care Clinics·José R Maldonado
Nov 26, 2008·Archives of Internal Medicine·Alok A KhoranaGary H Lyman
Oct 1, 2009·Critical Care Medicine·Brian B GrahamIvor S Douglas
Nov 26, 2009·Archives of Internal Medicine·John C WoolcottCarlo A Marra
Nov 10, 2010·Archives of Internal Medicine·Tamara G FongSharon K Inouye
Oct 5, 2011·The Journal of Nutrition, Health & Aging·C LafontUNKNOWN Members of I.A.G.G./A.M.P.A Task Force
Nov 19, 2011·Journal of the American Geriatrics Society·Prabha LakhanLeonard C Gray
Dec 17, 2011·Journal of the American Medical Informatics Association : JAMIA·Dawn W DowdingTerhilda Garrido
Nov 15, 2012·Journal of the American Geriatrics Society·Ethan U CumblerJohn Rush Pierce
Nov 22, 2012·Circulation. Cardiovascular Quality and Outcomes·T Bruce Ferguson
Nov 28, 2012·Journal of the American Geriatrics Society·Mary T FoxEllen Schraa
Apr 24, 2013·JAMA Internal Medicine·William W HungAlbert L Siu
Apr 24, 2013·JAMA Internal Medicine·Kellie L FloodCynthia J Brown
May 15, 2013·Age and Ageing·Franklin WouSimon Paul Conroy
May 23, 2013·Journal of the American Geriatrics Society·Mary T FoxKelly O'Brien
Jun 5, 2013·Journal of the American Geriatrics Society·Gillian K SteelFisherSharon K Inouye
Jun 19, 2013·Journal of the American Geriatrics Society·Elizabeth A CapezutiMarie P Boltz
Jun 26, 2013·Journal of the American Geriatrics Society·Jeannie K LeeMarie Chisholm-Burns
Aug 9, 2013·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Susannah Jane LongCharles Vincent
Apr 12, 2014·Annals of Internal Medicine·Kevin Quinn
May 31, 2014·Nursing Research and Practice·Harriet Udin AronowLinda Burnes Bolton

❮ Previous
Next ❯

Citations

Dec 9, 2017·The Journal of Nursing Administration·Lianna Zaven AnsryanLinda Burnes Bolton
Sep 14, 2017·Nursing Science Quarterly·Jacqueline Fawcett, Janice B Foust
Sep 5, 2018·Nursing Administration Quarterly·Lianna Z AnsryanLinda Burnes Bolton
Apr 24, 2019·Geriatrics·Kellie L FloodElla H Bowman
Sep 27, 2020·Journal of Health Organization and Management·Raffaella GualandiDaniela Tartaglini
Nov 30, 2018·Journal of Gerontological Nursing·Rebecca L TrottaMarie P Boltz
Oct 12, 2020·Geriatric Nursing·Nestor Neil A PeigPamela S Miller
Mar 30, 2021·Internal Medicine·Tomohiro F NishijimaUNKNOWN Japanese Association of Clinical Cancer Centers
May 22, 2021·Clinical Journal of Oncology Nursing·Sherry L RaftersLinda Lillington

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2021 Meta ULC. All rights reserved