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Hospitalized Older Adults (hospitalized + older_adult)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Translating Research into Practice Intervention Improves Management of Acute Pain in Older Hip Fracture Patients

HEALTH SERVICES RESEARCH, Issue 1 2009
Marita G. Titler
Objective. To test an interdisciplinary, multifaceted, translating research into practice (TRIP) intervention to (a) promote adoption, by physicians and nurses, of evidence-based (EB) acute pain management practices in hospitalized older adults, (b) decrease barriers to use of EB acute pain management practices, and (c) decrease pain intensity of older hospitalized adults. Study Design. Experimental design with the hospital as the unit of randomization. Study Setting. Twelve acute care hospitals in the Midwest. Data Sources. (a) Medical records (MRs) of patients ,65 years or older with a hip fracture admitted before and following implementation of the TRIP intervention and (b) physicians and nurses who care for those patients. Data Collection. Data were abstracted from MRs and questions distributed to nurses and physicians. Principal Findings. The Summative Index for Quality of Acute Pain Care (0,18 scale) was significantly higher for the experimental (10.1) than comparison group (8.4) at the end of the TRIP implementation phase. At the end of the TRIP implementation phase, patients in the experimental group had a lower mean pain intensity rating than those in the comparison group ( p<.0001). Conclusion. The TRIP intervention improved quality of acute pain management of older adults hospitalized with a hip fracture. [source]

After Adoption: Sustaining the Innovation A Case Study of Disseminating the Hospital Elder Life Program

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2005
Elizabeth H. Bradley PhD
Objectives: To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program (HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults. Design: Longitudinal, qualitative study between November 2000 and November 2003 based on 102 in-depth interviews every 6 months during HELP implementation. Setting: Thirteen hospitals implementing HELP. Participants: Forty-two hospital staff members (physician, nursing, volunteer, and administrative staff) implementing HELP, conducted 102 interviews. Measurements: Staff experiences sustaining the program, including challenges and strategies that they viewed as successful in addressing these challenges. Results: Of the 13 hospitals studied, 10 were sustaining HELP at the end of the study period; three terminated the program (after 24 months, 12 months, and 6 months). Critical factors were identified as influencing whether the program was sustained: the presence of clinical leadership, the ability and willingness to adapt the original HELP protocols to local hospital circumstances and constraints, and the ability to obtain longer-term resources and funding for HELP. Conclusion: Recognizing the need for sustained clinical leadership and funding as well as the inevitable modifications required to sustain innovative programs can promote more-realistic goals and expectations for health services researchers, clinicians, and policy makers in their laudable efforts to translate research into practice. [source]

Inappropriate medication use in hospitalized older adults,Is it time for interventions?,

JOURNAL OF HOSPITAL MEDICINE, Issue 2 2008
Daniel S. Budnitz MD
[source]

Situated clinical reasoning: Distinguishing acute confusion from dementia in hospitalized older adults

RESEARCH IN NURSING & HEALTH, Issue 2 2003
Marianne McCarthy
Abstract In this study a dimensional analysis approach was used to explore the clinical reasoning of nurses who care for hospitalized older adults to identify factors that might explain their failure to detect acute confusion and to distinguish it from dementia in this patient population. Data analysis yielded a grounded theory of situated clinical reasoning, which proposes that the ability of nurses to identify acute confusion varies widely. This variation can be attributed to the differences in nurses' philosophical perspectives on aging. According to this theory, three distinct perspectives are unwittingly embraced by nurses who care for older patients. These perspectives influence how nurses characterize aging and the aged and condition the ways in which they judge and ultimately deal with older adults in clinical situations. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:90,101, 2003 [source]