Functional Decline in Hospitalized Older Adults: Can Nursing Make a Difference?

Boltz, Marie; Resnick, Barbara; Capezuti, Elizabeth; Shuluk, Joseph; Secic, Michelle

doi:10.1016/j.gerinurse.2012.01.008

Cited by 97 publications

(86 citation statements)

References 33 publications

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“…The evaluation of the policies and environments that promoted functionality and physical activity was based on the checklists developed by Resnick et al 8 . These were translated and adapted by the researchers ( JT, LG and LN).…”

Section: Methodsmentioning

confidence: 99%

“…Based on the intrinsic and extrinsic etiology of the risk factors for HAD, Resnick et al 7 developed Function Focused Care (FFC) which aims to promote and achieve the highest degree of functionality and prevent physical and cognitive deconditioning. FFC is based on the Social-Ecological Model that frames the interrelationship between intrapersonal, interpersonal, environmental and political factors, which may contribute to the impact of hospitalization on the elderly 8 . The use of this model is also fundamental in guiding the implementation process of FFC to benefit these users 8 .…”

Section: Introductionmentioning

confidence: 99%

“…FFC is based on the Social-Ecological Model that frames the interrelationship between intrapersonal, interpersonal, environmental and political factors, which may contribute to the impact of hospitalization on the elderly 8 . The use of this model is also fundamental in guiding the implementation process of FFC to benefit these users 8 . This process includes four steps: a) assessment of policies and environment; b) education; c) setting goals/objectives for FFC; and d) motivation and mentoring.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of hospital environments and policies: seeking an age-friendly hospital

Tavares

Grácio

Nunes

2017

Rev. bras. geriatr. gerontol.

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Functional decline is one of the main problems arising from the hospitalization of elderly persons. Hospital environments and policies focused on functionality are crucial for diminishing disabilities associated with hospitalization. This observational study was performed in four internal medicine services and aimed to evaluate the hospital environment and policies as an integral step in implementing the Function-Focused Care (FFC) programme being established in Portugal. The results of the hospital environment analysis suggest that design and product support, while present, are limited given the needs, complexities and specificities of hospitalized elderly persons. Policy evaluation indicated the existence of institutional projects that reflect a concern with functionality. However, more than half of the criteria evaluated need to be developed further in order to integrate the FFC programme. These results highlight that, while these services aim to be more "age-friendly environments", a number of initiatives can and should be undertaken in order to guide the FFC implementation process. This will benefit patients and their families, professionals and institutions.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of hospital environments and policies: seeking an age-friendly hospital

Tavares

Grácio

Nunes

2017

Rev. bras. geriatr. gerontol.

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“…Avoiding emergency hospital admissions in elderly population is a major interest for public administrations. Thus, early identification of profiles of patients at risk may facilitate the implementation of interventions to save potential costs related to healthcare utilization (Lehnert et al, 2011) and to avoid and/or decrease the functional decline and impairment of quality of life and physical and cognitive status in elderly people (Boltz et al, 2012;Merino & Cruz-Jentoft, 2012). …”

Section: Introductionmentioning

confidence: 99%

Development of a Predictive Model of Elderly Patients at Risk of Future Hospital Admission at Primary Care Centres in Valencia (Spain)

Doñate-Martínez¹,

Ródenas-Rigla²,

Garcés‐Ferrer³

2017

Eur. j. interdiscip. stud.

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This paper presents the development of a new predictive model of elders at risk of suffering hospital admissions in the subsequent year in Valencia (Spain), based on primary care experts' discussions and consensus. The study involves three main stages. Firstly, Focus Group methodology with six primary care experts to design the first set of variables of the model. Subsequently, two retrospective studies to analyse the performance of the selected variables in a pilot sample (n=107) and to design the predictive model in a development sample (n=343). Data was collected from electronic medical records and consulting the professional of reference. Logistic regression analysis identified five variables as predictors of hospital admissions during the subsequent year of the development cohort: diagnosis of chronic heart diseases, chronic respiratory diseases, diabetes, presence of palliative care and number of previous visits to the hospital emergency department. A risk scoring system was developed for each patient from 0 to 1, with a cut-off point of 0. 5. The model had a sensitivity of 42%, specificity of 96% and AUC of 0. 764. Our predictive model identifies with moderate efficiency elderly patients at risk of suffering future hospital admissions. Additionally, this first screening could be extended through a second phase aimed to assess social variables which are very relevant in the current economic context in Spain. Further research is needed to validate these results with larger samples, and to explore their applicability in other health and social care settings.

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“…[15] Nurses in acute care settings play a key role in identifying problems and targeting interventions to prevent a decline in functional ability and to maintain self-care capacity. [16] The often short length of stay and the complexities of this patient group make documentation crucial in order to pass on important knowledge in the health care system. According to national Danish guidelines, nursing documentation should contain core areas such as: nutritional status, pain, sleep, urinary-and bowel elimination, skin and tissue, cognitive and psychosocial factors.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of nursing documentation of acutely admitted older home-living medical patients in a Danish hospital

Sivertsen

Juul‐Larsen

Petersen

et al. 2017

CNS

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Background: Documentation enhances patient safety and continuity. According to national Danish guidelines, nursing documentation should contain core areas such as: nutritional status, pain, sleep, urinary-and bowel elimination, skin and tissue, cognitive and psychosocial factors. Documentation practice and its association to patient impairments have not been examined as a comprehensive, combined set of nursing core areas in acutely admitted older medical patients. Therefor the objective of this study was to examine levels of nursing documentation and the associations between documentation levels and patient impairments. Methods: A descriptive study of acutely admitted patients above 65 years old. Audit of handwritten nursing records and structured patient interviews were conducted to assess eight core areas based on the national Danish guidelines for nursing documentation: nutritional status, pain, sleep, urinary-and bowel elimination, skin and tissue, cognitive and psychosocial factors. Furthermore measures of Charlson Comorbidity Index (CCI) and self-reported health were collected. Results: 90 acutely admitted medical patients ≥ 65 years were enrolled. The prevalence of documentation was between 4 and 80%. We found a higher prevalence of unstructured documentation. Looking at six of the eight core areas, 33% of the patients had 0-2 areas documented. For all the eight core areas we found no difference in the prevalence of documentation for patients with impairment compared to patients without impairment, nor did we find a significant association between patient documentation and age, sex, CCI, or self-rated health. Conclusions:The results implies that something else than national guidelines, patient impairments, age, sex, CCI and self-rated health of the patient are determining whether documentation is done or not.

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Functional Decline in Hospitalized Older Adults: Can Nursing Make a Difference?

Cited by 97 publications

References 33 publications

Assessment of hospital environments and policies: seeking an age-friendly hospital

Assessment of hospital environments and policies: seeking an age-friendly hospital

Development of a Predictive Model of Elderly Patients at Risk of Future Hospital Admission at Primary Care Centres in Valencia (Spain)

An evaluation of nursing documentation of acutely admitted older home-living medical patients in a Danish hospital

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