Targeting Older Adults at Risk of Adverse Events During Hospitalization: Development of the Pre-Hospital Risk Index Profile (Pre-RIP)

2.50
Hdl Handle:
http://hdl.handle.net/10755/163168
Category:
Abstract
Type:
Presentation
Title:
Targeting Older Adults at Risk of Adverse Events During Hospitalization: Development of the Pre-Hospital Risk Index Profile (Pre-RIP)
Author(s):
Roberge, Barbara J.; Mahoney, Ellen K.; Chuang, Sung-Kiang; Minaker, Kenneth L.; Leahy, Kathleen B.; Parks, Lauren
Author Details:
Barbara J. Roberge, PhD, APRN, BC, Massachusetts General Hospital, Boston, Massachusetts, USA, email: broberge@partners.org; Ellen K. Mahoney DNS, RN; Sung-Kiang Chuang MD; Kenneth L. Minaker, MD; Kathleen B. Leahy, BSN, RN, Institute of Health Professions, Massachusetts General Hospital; Lauren Parks, BSN, RN, Boston College School of Nursing
Abstract:
Purpose: To develop a pre-hospital index for older adults (OA) to identify risk of adverse outcomes during hospitalization. This is Phase 1 of a 3-Phase project that is part of the Robert Wood Johnson Interdisciplinary Nursing Quality Research Initiative. Theoretical Framework: Theory building study based on Symptom Interactional Framework. Methods (Design, Sample, Setting, Measures, Analysis): Cross sectional survey design using retrospective chart review. To develop the risk assessment tool, ambulatory medical record reviews are conducted on hospitalized OAs from a geriatric primary care practice. A hospitalized group (N = 200) is compared with a random sample of non-hospitalized OAs from the same practice (N = 100) to assess discriminate validity. Index variables selected by review of the literature, expert opinion and data availability include; sociodemographic, functional, diagnostic, laboratory, cognitive, physical, nutritional and social risk factors, twelve months proceeding hospitalization. Statistical models will be developed using logistic and multinomial regression analysis, predicting hospitalization and, once hospitalized, adverse event and discharge location. Between groups analysis will be performed. Results: To date we have completed 40 medical record reviews (age range 74-93; 50% women). Factors placing patients 'at risk' are frequent with one-forth having a diagnosis of dementia, close to 50% walk with an assistive device and 25% live alone. Unique to this study, a level of help-seeking behavior is seen in the month prior to hospitalization. Therefore, the number of ambulatory practice contacts, including telephone calls and office and emergency visits are analyzed as additional risk predictors. Conclusions and Implications: In future studies we will test the risk index prospectively in hospitalized OAs and target nursing interventions using the Risk Index Profile. Due to frailty, disease and disability, older adults are at greater risk of adverse events when hospitalized. Identifying risk early in the hospitalization has the potential to improve measures of nurse sensitive quality of care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
19th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Providence, Rhode Island, USA
Description:
Conference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleTargeting Older Adults at Risk of Adverse Events During Hospitalization: Development of the Pre-Hospital Risk Index Profile (Pre-RIP)en_GB
dc.contributor.authorRoberge, Barbara J.en_US
dc.contributor.authorMahoney, Ellen K.en_US
dc.contributor.authorChuang, Sung-Kiangen_US
dc.contributor.authorMinaker, Kenneth L.en_US
dc.contributor.authorLeahy, Kathleen B.en_US
dc.contributor.authorParks, Laurenen_US
dc.author.detailsBarbara J. Roberge, PhD, APRN, BC, Massachusetts General Hospital, Boston, Massachusetts, USA, email: broberge@partners.org; Ellen K. Mahoney DNS, RN; Sung-Kiang Chuang MD; Kenneth L. Minaker, MD; Kathleen B. Leahy, BSN, RN, Institute of Health Professions, Massachusetts General Hospital; Lauren Parks, BSN, RN, Boston College School of Nursingen_US
dc.identifier.urihttp://hdl.handle.net/10755/163168-
dc.description.abstractPurpose: To develop a pre-hospital index for older adults (OA) to identify risk of adverse outcomes during hospitalization. This is Phase 1 of a 3-Phase project that is part of the Robert Wood Johnson Interdisciplinary Nursing Quality Research Initiative. Theoretical Framework: Theory building study based on Symptom Interactional Framework. Methods (Design, Sample, Setting, Measures, Analysis): Cross sectional survey design using retrospective chart review. To develop the risk assessment tool, ambulatory medical record reviews are conducted on hospitalized OAs from a geriatric primary care practice. A hospitalized group (N = 200) is compared with a random sample of non-hospitalized OAs from the same practice (N = 100) to assess discriminate validity. Index variables selected by review of the literature, expert opinion and data availability include; sociodemographic, functional, diagnostic, laboratory, cognitive, physical, nutritional and social risk factors, twelve months proceeding hospitalization. Statistical models will be developed using logistic and multinomial regression analysis, predicting hospitalization and, once hospitalized, adverse event and discharge location. Between groups analysis will be performed. Results: To date we have completed 40 medical record reviews (age range 74-93; 50% women). Factors placing patients 'at risk' are frequent with one-forth having a diagnosis of dementia, close to 50% walk with an assistive device and 25% live alone. Unique to this study, a level of help-seeking behavior is seen in the month prior to hospitalization. Therefore, the number of ambulatory practice contacts, including telephone calls and office and emergency visits are analyzed as additional risk predictors. Conclusions and Implications: In future studies we will test the risk index prospectively in hospitalized OAs and target nursing interventions using the Risk Index Profile. Due to frailty, disease and disability, older adults are at greater risk of adverse events when hospitalized. Identifying risk early in the hospitalization has the potential to improve measures of nurse sensitive quality of care.en_GB
dc.date.available2011-10-27T11:02:35Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:02:35Z-
dc.conference.date2007en_US
dc.conference.name19th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationProvidence, Rhode Island, USAen_US
dc.descriptionConference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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