Making hospitals safer for older adults: updating quality metrics by understanding hospital-acquired delirium and its link to falls

The Permanente Journal
Eric A LeeTeri L Whiffen

Abstract

The medical care of hospitalized geriatric patients must differ from the care of younger adults. Because of reduced "reserve capacity," hospitalized older adults are at high risk of development of geriatric syndromes such as delirium and falls. Geriatric syndromes often lead to functional decline and dependence. Patients who experience geriatric syndromes in the hospital are more likely to have a longer length of stay, higher risk of readmissions, and worse medical outcomes. Incident delirium in hospitalized geriatric patients has been shown to be preventable by intervening in established risk factors. Prevention of hospital-related falls has not been consistently demonstrated. Analysis from Kaiser Permanente data demonstrated a correlation with delirium and hospital-related falls. We propose that age-specific quality metrics should be made to reduce the risk of the development of geriatric syndromes in hospitalized older adults. By preventing delirium, we believe that health care practitioners can reduce hospital-related falls in geriatric patients and improve the quality of care delivered to hospitalized older adults. An illustrative fictional case study is presented.

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Citations

Nov 8, 2014·Journal of Nursing Management·Rhonda L BabineSarah Hallen
Apr 12, 2016·Psychosomatics·Rhonda L BabineHeidi R Wierman
Feb 8, 2018·Revista brasileira de enfermagem·Melissa de Freitas LuziaAmália de Fátima Lucena
Aug 6, 2019·Aging Clinical and Experimental Research·Irene MansuttiUNKNOWN ESAMED team
Jan 1, 2017·Journal of the American Geriatrics Society·Kumar DharmarajanSharon K Inouye
Jan 31, 2018·Clinical Nursing Research·Barbara WatsonAleksandra Zecevic
Sep 11, 2021·Scientific Reports·Tomoko NakanishiKoichiro Usuku

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