44023Institute for Healthcare Improvement, Cambridge, MA, USA.
44194The John A. Hartford Foundation, New York, NY, USA.
J Aging Health. 2021 Aug-Sep;33(7-8):469-481. doi: 10.1177/0898264321991658. Epub 2021 Feb 8.
An expert panel reviewed and summarized the literature related to the evidence for the 4Ms-what matters, medication, mentation, and mobility-in supporting care for older adults. In 2017, geriatric experts and health system executives collaborated with the Institute for Healthcare Improvement (IHI) to develop the 4Ms framework. Through a strategic search of the IHI database and recent literature, evidence was compiled in support of the framework's positive clinical outcomes. Asking what matters from the outset of care planning improved both psychological and physiological health statuses. Using screening protocols such as the Beers' criteria inhibited overprescribing. Mentation strategies aided in prevention and treatment. Fall risk and physical function assessment with early goals and safe environments allowed for safe mobility. Through a framework that reduces cognitive load of providers and improves the reliability of evidence-based care for older adults, all clinicians and healthcare workers can engage in age-friendly care.
一个专家小组审查并总结了与 4Ms(重要的事、药物、心理状态和活动能力)相关的文献,以支持对老年人的护理。2017 年,老年病专家和医疗系统高管与改善医疗保健研究所(IHI)合作开发了 4Ms 框架。通过对 IHI 数据库和最新文献的策略性搜索,收集了支持该框架产生积极临床结果的证据。从护理计划开始就询问重要的事,改善了心理和生理健康状况。使用药物使用筛查方案,如 Beers 标准,可抑制过度用药。心理状态策略有助于预防和治疗。通过早期目标和安全环境进行跌倒风险和身体功能评估,实现安全活动能力。通过一个减轻提供者认知负担并提高基于证据的老年护理可靠性的框架,所有临床医生和医疗工作者都可以参与到对老年人友好的护理中。