2.50
Hdl Handle:
http://hdl.handle.net/10755/164093
Category:
Abstract
Type:
Presentation
Title:
Preventing Functional Decline Among Hospitalized Older Adults to Increase Discharges to Home
Author(s):
Lee, Sonia; Staffileno, Beth; Fogg, Louis
Author Details:
Sonia Lee, MS, GCNS-BC, BSN, North Shore University Health System-Skokie Hospital, Skokie, Illinois, USA, email: slee@carecenter.org; Beth Staffileno, PhD, FAHA, BSN; Louis Fogg, PhD
Abstract:
PURPOSE/OBJECTIVES: The purpose of the study was to increase the discharge rate to home and reduce complications associated with hospitalization for patients who are 75 years old and older admitted from home. SIGNIFICANCE: The preservation of function is important since decreased function in older adults due to hospitalization is a common adverse effect which can prevent patients from returning home. The nursing assistants play a main role in providing care to the patients. DESIGN: The 9-month quasi-experimental study was conducted on a 34-bed medical unit in a community teaching-hospital. The study was designed to have a power of 84%. Data were analyzed using descriptive statistics and paired T-tests. METHODS: The gerontological CNS conducted workshops on best geriatric practices for the nursing staff. Nursing assistants revised their shift routines utilizing this new knowledge and prioritized tasks to prevent hospital complications. Nurses used Katz ADL to ask patients about their function before illness and at discharge. Patients were excluded if transferred in or out of the unit, stayed less than 23-hours or had admitting diagnosis effecting function. FINDINGS: We enrolled 499 subjects who were at least 75 year-old admitted from home. We discharged 74% of these patients back home. Compared to previous year, there was a significant decrease in prevalence of nosocomial pressure ulcers (10.7% versus 5.9%, P<0.05), no changes in the length of stay (4.2 versus 4.3), or fall rate (5.02 versus 5.11). There was no clinical change in patients' function as indicated by the mean ADL score before illness and at discharge (4.6 versus 4.4, P=0.03). CONCLUSIONS: The return home rate of 74% is significant compared to 60% in our pilot study used to measure the baseline. Patients' function was preserved during hospitalization as indicated by the mean ADL scores. IMPLICATIONS FOR PRACTICE: Data suggest that education, staff participation and revised care routines of nursing assistants are key components to return frail patients to the haven of their homes and reduce the hospital complications.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USA
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.titlePreventing Functional Decline Among Hospitalized Older Adults to Increase Discharges to Homeen_GB
dc.contributor.authorLee, Soniaen_US
dc.contributor.authorStaffileno, Bethen_US
dc.contributor.authorFogg, Louisen_US
dc.author.detailsSonia Lee, MS, GCNS-BC, BSN, North Shore University Health System-Skokie Hospital, Skokie, Illinois, USA, email: slee@carecenter.org; Beth Staffileno, PhD, FAHA, BSN; Louis Fogg, PhDen_US
dc.identifier.urihttp://hdl.handle.net/10755/164093-
dc.description.abstractPURPOSE/OBJECTIVES: The purpose of the study was to increase the discharge rate to home and reduce complications associated with hospitalization for patients who are 75 years old and older admitted from home. SIGNIFICANCE: The preservation of function is important since decreased function in older adults due to hospitalization is a common adverse effect which can prevent patients from returning home. The nursing assistants play a main role in providing care to the patients. DESIGN: The 9-month quasi-experimental study was conducted on a 34-bed medical unit in a community teaching-hospital. The study was designed to have a power of 84%. Data were analyzed using descriptive statistics and paired T-tests. METHODS: The gerontological CNS conducted workshops on best geriatric practices for the nursing staff. Nursing assistants revised their shift routines utilizing this new knowledge and prioritized tasks to prevent hospital complications. Nurses used Katz ADL to ask patients about their function before illness and at discharge. Patients were excluded if transferred in or out of the unit, stayed less than 23-hours or had admitting diagnosis effecting function. FINDINGS: We enrolled 499 subjects who were at least 75 year-old admitted from home. We discharged 74% of these patients back home. Compared to previous year, there was a significant decrease in prevalence of nosocomial pressure ulcers (10.7% versus 5.9%, P<0.05), no changes in the length of stay (4.2 versus 4.3), or fall rate (5.02 versus 5.11). There was no clinical change in patients' function as indicated by the mean ADL score before illness and at discharge (4.6 versus 4.4, P=0.03). CONCLUSIONS: The return home rate of 74% is significant compared to 60% in our pilot study used to measure the baseline. Patients' function was preserved during hospitalization as indicated by the mean ADL scores. IMPLICATIONS FOR PRACTICE: Data suggest that education, staff participation and revised care routines of nursing assistants are key components to return frail patients to the haven of their homes and reduce the hospital complications.en_GB
dc.date.available2011-10-27T11:41:54Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:54Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_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.en_US
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