2.50
Hdl Handle:
http://hdl.handle.net/10755/182484
Category:
Abstract
Type:
Presentation
Title:
Delirium Management: Cost Savings and Falls Reduction
Author(s):
Francisco, Mary Ann
Author Details:
Mary Ann Francisco, MSN CCRN GCNS-BC, University of Chicago Medical Center, Chicago, Illinois, USA, email: maryann.francisco@uchospitals.edu
Abstract:
Preventing falls in hospitalized patients with delirium and multiple co-morbidities can be quite challenging. Additional resources such as sitters are often implemented, as a measure to prevent patient falls and self-harm. However, these measures are costly and their merit is often not measurable. In an effort to ensure patient safety, improve patient outcomes, and decrease health care costs, an evidence-based delirium management program was implemented. The program was based on the HELP (Hospitalized Elder Life Program), NICHE (Nursing Improving the Care of Health System Elders), ACE (Acute Care of Elders), and GRN (Geriatric Resource Nurse) models. Delirium protocols including frequent safety checks, cognitive orientation, toileting/personal care, comfort measures, hydration/nutrition management, sensory support, mobility and sleep promotion were implemented. Two advanced practice nurses with expertise in gerontological nursing collaborated with nursing leadership to develop and implement all phases of the program, including nursing education. First year results of the program showed sustained decreases in the average number of falls per quarter going from 2.5 to 0.5 per 1000 patient days. Results from our efforts also reflect a mean reduction in the number of sitter hours per month going from 3994 sitter hours per month pre implementation to 2858 sitter hours per month post implementation. These reductions are equivalent to over 4.5 full time nursing assistants. Ongoing implementation of the program continues to reflect cost savings and reductions in falls. These findings are particularly encouraging given the need for improved patient outcomes and the current changes in reimbursements for preventable patient injuries. Reference: Balas, MC, Gale, M, and Kagan SH. (2004). Delirium doulas. An innovative approach to enhance care for critically ill older adults. Critical Care Nurse. 2004, 24, (1): 36-46. ; Boswell, DJ, Ramsey, J, Smith, MA and Wagers, B (2001). The cost- effectiveness of a patient-sitter program in an acute care hospital: a test of the impact of sitters on the incidence of falls and patient satisfaction. Quality Management in Health Care, 2001, 10 (1):10-16.; Bradley, EH, Tashonna RW, Schlesinger, M, Baker, D, and Inouye SK. (2006). Patterns of diffusion of evidence-based clinical programmes: a case study of Hospital Elder Life Program. Quality and Safety in Health Care. 2006, 15: 334-338.; Palmisano-Mills, C. (2007). Common problems in hospitalized older adults. Journal of Gerontological Nursing, 2007, 33 (1): 48-54.; Salamon, L, Lennnon, M. (2003) Decreasing companion usage without negatively affecting patient outcomes: a performance improvement project. Medical-Surgical Nursing, 2003, 13 (4): 230-236.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2009
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Louisville, Kentucky, USA
Description:
"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, 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.titleDelirium Management: Cost Savings and Falls Reductionen_GB
dc.contributor.authorFrancisco, Mary Annen_US
dc.author.detailsMary Ann Francisco, MSN CCRN GCNS-BC, University of Chicago Medical Center, Chicago, Illinois, USA, email: maryann.francisco@uchospitals.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/182484-
dc.description.abstractPreventing falls in hospitalized patients with delirium and multiple co-morbidities can be quite challenging. Additional resources such as sitters are often implemented, as a measure to prevent patient falls and self-harm. However, these measures are costly and their merit is often not measurable. In an effort to ensure patient safety, improve patient outcomes, and decrease health care costs, an evidence-based delirium management program was implemented. The program was based on the HELP (Hospitalized Elder Life Program), NICHE (Nursing Improving the Care of Health System Elders), ACE (Acute Care of Elders), and GRN (Geriatric Resource Nurse) models. Delirium protocols including frequent safety checks, cognitive orientation, toileting/personal care, comfort measures, hydration/nutrition management, sensory support, mobility and sleep promotion were implemented. Two advanced practice nurses with expertise in gerontological nursing collaborated with nursing leadership to develop and implement all phases of the program, including nursing education. First year results of the program showed sustained decreases in the average number of falls per quarter going from 2.5 to 0.5 per 1000 patient days. Results from our efforts also reflect a mean reduction in the number of sitter hours per month going from 3994 sitter hours per month pre implementation to 2858 sitter hours per month post implementation. These reductions are equivalent to over 4.5 full time nursing assistants. Ongoing implementation of the program continues to reflect cost savings and reductions in falls. These findings are particularly encouraging given the need for improved patient outcomes and the current changes in reimbursements for preventable patient injuries. Reference: Balas, MC, Gale, M, and Kagan SH. (2004). Delirium doulas. An innovative approach to enhance care for critically ill older adults. Critical Care Nurse. 2004, 24, (1): 36-46. ; Boswell, DJ, Ramsey, J, Smith, MA and Wagers, B (2001). The cost- effectiveness of a patient-sitter program in an acute care hospital: a test of the impact of sitters on the incidence of falls and patient satisfaction. Quality Management in Health Care, 2001, 10 (1):10-16.; Bradley, EH, Tashonna RW, Schlesinger, M, Baker, D, and Inouye SK. (2006). Patterns of diffusion of evidence-based clinical programmes: a case study of Hospital Elder Life Program. Quality and Safety in Health Care. 2006, 15: 334-338.; Palmisano-Mills, C. (2007). Common problems in hospitalized older adults. Journal of Gerontological Nursing, 2007, 33 (1): 48-54.; Salamon, L, Lennnon, M. (2003) Decreasing companion usage without negatively affecting patient outcomes: a performance improvement project. Medical-Surgical Nursing, 2003, 13 (4): 230-236.en_GB
dc.date.available2011-10-28T15:26:16Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:26:16Z-
dc.conference.date2009en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationLouisville, Kentucky, USAen_US
dc.description"Magnet: Inspiring Innovation, Achieving Outcomes" was the theme and "Explore the relationship among leadership, innovation, and nursing practice outcomes" was the goal of the 13th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 1-3 October, 2009 in Louisville, Kentucky, USA.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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