Impact of Hospital Design on Acutely Unwell Patients with Dementia

Young, Caitlin; Edwards, Chris; Singh, Inderpal

doi:10.3390/geriatrics2010004

Cited by 4 publications

(15 citation statements)

References 33 publications

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“…A subsequent study by Young et al . ( 9 ) at the same sites revealed similar results with regard to greater LoS among those admitted to single rooms; however, they found no significant difference in the number of recurrent fallers between the two hospitals. In this study, patients in single rooms had significantly better pre-admission levels of independence as measured by the Barthel Index ADLs ( p = .05).…”

Section: Interventions Typesmentioning

confidence: 65%

Optimizing the Physical & Social Environment Within Hospitals for Patients with Dementia: a Systematic Review

2022

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BackgroundAs the population ages, the number of individuals living with dementia is increasing. This has implications for the health-care system, as people living with dementia are hospitalized more frequently and for longer periods. Because patients living with dementia are at increased risk for adverse events during admission, understanding how the acute care physical and social environments influence their outcomes is impera-tive. Thus, the objective of this review was to identify studies that modified the physical and/or social environment in acute care in order to improve care for hospitalized patients living with dementia. MethodsMEDLINE, Embase, and CINAHL databases were used to search for articles up to and including June 2021. PRISMA guidelines were followed. Two independent reviewers as-sessed citations and full texts against the following inclusion criteria: patients living with dementia/cognitive impairment, presence of a control group, and evidence of clinical or health systems outcomes. All published English-language articles meeting inclusion criteria were retrieved. ResultsFollowing the database search, 12,901 citations were retrieved with 11,334 remaining after duplication removal. Of these, 15 papers met inclusion criteria. Seven studies evaluated the physical environment (e.g., addition of electronic sensor alarms and environmental cues). The remaining studies evalu-ated specific programs (e.g., art, music, exercise, volunteer engagement, and virtual reality). The majority of studies were low to very low quality; only three studies were RCTs. Environmental cues may initially improve wayfinding, and exercise may reduce neuropsychiatric symptoms. ConclusionsAlthough there are several interventions, there is a lack of high-quality evidence available to determine what exactly needs to be incorporated into acute care settings to reduce adverse outcomes for patients with dementia.

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Section: Interventions Typesmentioning

confidence: 65%

Optimizing the Physical & Social Environment Within Hospitals for Patients with Dementia: a Systematic Review

2022

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“…A higher incidence of inpatient fall has also been reported from single rooms [5,6,7,8], particularly in those with dementia [10,22]. Although following quality initiatives the fall rate has been lower [14,17], the long-term impact of such intervention has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…To investigate the impact of inpatient fall, clinical outcome data were collected for individual patients including the length of stay (LOS), discharge destination, and inpatient fall-associated injury [17]. The mortality data was updated to the end of 31 December 2017.…”

Section: Methodsmentioning

confidence: 99%

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One-Year Mortality Rates Before and After Implementing Quality-Improvement Initiatives to Prevent Inpatient Falls (2012–2016)

2018

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Single-room ward design has previously been associated with increased risk of inpatient falls and adverse outcomes. However, following quality initiatives, the incidence of inpatient falls has shown a sustained reduction. Benefits have also been observed in the reduction of hip fractures. However, one-year mortality trends have not been reported. The aim of this observational study is to report the trends in one-year mortality rates before and after implementing quality-improvement initiatives to prevent inpatient falls over the last 5 years (2012)(2013)(2014)(2015)(2016). This retrospective observational study was conducted for all patients who had sustained an inpatient fall between January 2012 and December 2016. All the incident reports in DATIX patient-safety software which were completed for each inpatient fall were studied, and the clinical information was extracted from Clinical Work Station software. Mortality data were collected on all patients for a minimum of one year following the discharge from the hospital. The results show that 95% patients were admitted from their own homes; 1704 patients had experienced 3408 incidents of an inpatient fall over 5 years. The mean age of females (82.61 ± 10.34 years) was significantly higher than males (79.36 ± 10.14 years). Mean falls/patient = 2.0 ± 2.16, range 1-33). Mean hospital stay was 45.43 ± 41.42 days. Mean hospital stay to the first fall was 14.5 ± 20.79 days, and mean days to first fall prior to discharge was 30.8 ± 34.33 days. The results showed a significant and sustained reduction in the incidence of inpatient falls. There was a downward trend in the incidence of hip fractures over the last two years. There was no significant difference in the inpatient and 30-day mortality rate over the last five years. However, mortality trends appear to show a significant downward trend in both six-month and one-year mortality rates over the last two years following the implementation of quality initiatives to prevent inpatient falls. A significant reduction in the incidence of inpatient falls following quality initiatives initially has been observed, followed by a downward trend in the incidence of hip fractures. We have just started to observe a significant reduction in the 6-month and one-year mortality. We propose prompt completion of multifactorial falls risk assessments, and every possible quality initiative should be taken to prevent a 'first inpatient fall', which should result in the sustained improvement of clinical outcomes.

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“…The clinical assessment of older people with disability and impairments in body functioning is challenging. Nearly two-thirds of people admitted to hospitals are over 65 years old [ 10 ] and have been diagnosed with PD or dementia [ 11 ]. In the case of acute illnesses, individuals older than 65 years face a significantly longer length of hospital stay than those younger than 65 years do.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Power Rehabilitation Actions Using a Fuzzy Inference Method

Huang

Kuo

Basanta

et al. 2021

Int. J. Fuzzy Syst.

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The older population faces a high probability of experiencing age-related problems, such as osteoporosis, immobility, gait disturbances, stroke, Parkinson’s disease, and cognitive behavioral functional difficulties. Such problems negatively affect their lives. Thus, access to long-term care is a critical issue for older adults. In response to the aforementioned serious health issues, society must strive to provide a supportive and effective rehabilitation environment for older adults. This study designed an intelligent active and passive limb rehabilitation system to track and quantify the effectiveness of joint movements in patients automatically. The proposed method uses a camera and PoseNet to capture key feature information regarding human skeleton nodes and identify rehabilitation actions through joint movements. In addition, to solve the problem of joint occlusion during joint angle measurement, the designed system is equipped with a self-designed inertial measurement unit with GY-85 nine-axis sensors, which are mounted on the occluding part of the joints. A fuzzy inference system was developed to provide scores, suggestions, and encouragement for each rehabilitation session. This system also provides an interactive interface for users to monitor each rehabilitation session and examine whether rehabilitation is performed accurately.

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Impact of Hospital Design on Acutely Unwell Patients with Dementia

Cited by 4 publications

References 33 publications

Optimizing the Physical & Social Environment Within Hospitals for Patients with Dementia: a Systematic Review

Optimizing the Physical & Social Environment Within Hospitals for Patients with Dementia: a Systematic Review

One-Year Mortality Rates Before and After Implementing Quality-Improvement Initiatives to Prevent Inpatient Falls (2012–2016)

Evaluating Power Rehabilitation Actions Using a Fuzzy Inference Method

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