Effects of a nursing care program focused on basic self-care in older acute medical in-patients: a randomized controlled trial

Abstract

Background: Acute illness and hospitalization are often associated with decreased independence in basic activities of daily living. The aim of this study was to test the hypothesis that a nursing care program focused on basic self-care (N_BSC) improves functional outcomes in older patients admitted to an acute medical unit. Methods: This was a 2-group randomized controlled trial with repeated measures: 182 older patients admitted to an acute medical unit were randomly allocated to the usual care group (n = 91) and intervention group (n = 91). The intervention consisted of nursing care centered on basic self-care that includes promotion of daily walking and all daytime meals seated, out of bed. The main outcome was changes in the number of independent basic activities of daily living (BADL) from 2 weeks before admission (baseline) to discharge. Results: There was significant effect of the N_BSC on the outcomes. Changes from baseline to discharge in the number of independent BADL differ significantly between the intervention and usual care group. Intervention group patients were discharged with a superior functional status than usual care group. On discharge they were able to perform independently 2.93 BADL, whereas usual care patients performed independently 1.90 BADL ( P < .001). Conclusions: N_BSC for hospitalized older adults was feasible and program participants were discharged with better functional status than a clinically similar comparison group. N_BSC could be readily adapted for use in other hospitals and warrants further evaluation as a potential new tool for improving outcomes for hospitalized older patients.

Early Mobilisation and Exercise After Fragility Fracture

“…Nursing care programmes emphasising basic self-care can be helpful in improving functional outcomes among older patients hospitalised [67].…”

‘Our Voices Aren't Being Heard’: A qualitative descriptive study of nurses' perceptions of interprofessional collaboration in care supporting older people's functioning during a hospital stay

“…Older people (aged 65+) admitted to hospital for acute illnesses or injuries are highly susceptible to functional decline and related complications [1]. Accordingly, optimising functioning for this patient population is a high priority in many jurisdictions such as the United States [2], Canada [3][4][5], Australia [6], the European Union [7,8], South America [9] and Israel [10]. With this priority in mind, a body of international literature has emphasised the importance of care-oriented towards improving physical and cognitive functional outcomes for older people during a hospital stay [11][12][13][14][15].…”