Department of Geriatric Medicine, University Hospitals Leuven, Dienst Geriatrie UZ Leuven, Herestraat 49, Box 7003 35, 3000, Leuven, Belgium.
Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Eur Geriatr Med. 2023 Apr;14(2):239-249. doi: 10.1007/s41999-023-00748-3. Epub 2023 Jan 24.
To explore geriatric care for surgical patients in Belgian hospitals and geriatricians' reflections on current practice.
A web-based survey was developed based on literature review and local expertise, and was pretested with 4 participants. In June 2021, the 27-question survey was sent to 91 heads of geriatrics departments. Descriptive statistics and thematic analysis were performed.
Fifty-four surveys were completed, corresponding to a response rate of 59%. Preoperative geriatric risk screening is performed in 25 hospitals and systematically followed by geriatric assessment in 17 hospitals. During the perioperative hospitalisation, 91% of geriatric teams provide non-medical and 82% provide medical advice. To a lesser extent, they provide geriatric protocols, geriatric education and training, and attend multidisciplinary team meetings. Overall, time allocation of geriatric teams goes mainly to postoperative evaluations and interventions, rather than to preoperative assessment and care planning. Most surgical patients are hospitalised on surgical wards, with reactive (73%) or proactive (46%) geriatric consultation. In 36 hospitals, surgical patients are also admitted on geriatric wards, predominantly orthopaedic/trauma, abdominal and vascular surgery. Ninety-eight per cent of geriatricians feel that more geriatric input for surgical patients is needed. The most common reported barriers to further implement geriatric-surgical services are shortage of geriatricians and geriatric nurses, and unadjusted legislation and financing.
Geriatric care for surgical patients in Belgian hospitals is mainly reactive, although geriatricians favour more proactive services. The main opportunities and challenges for improvement are to resolve staff shortages in the geriatric work field and to update legislation and financing.
探讨比利时医院外科患者的老年护理以及老年病医生对当前实践的反思。
基于文献回顾和当地专业知识，开发了一个网络调查，并在 4 名参与者中进行了预测试。2021 年 6 月，向 91 个老年病学部门的负责人发送了这份 27 个问题的调查。采用描述性统计和主题分析进行分析。
完成了 54 份调查，响应率为 59%。25 家医院进行了术前老年风险筛查，17 家医院系统地进行了老年评估。在围手术期住院期间，91%的老年病团队提供非医疗建议，82%提供医疗建议。在较小程度上，他们提供老年病协议、老年病教育和培训，并参加多学科团队会议。总体而言，老年病团队的时间分配主要用于术后评估和干预，而不是术前评估和护理计划。大多数外科患者在外科病房住院，接受反应性（73%）或主动（46%）老年咨询。在 36 家医院中，外科患者也被收治在老年病房，主要是骨科/创伤科、腹部和血管外科。98%的老年病医生认为，外科患者需要更多的老年病学投入。进一步实施老年病-外科服务的最常见报告障碍是老年病医生和老年病护士短缺，以及立法和融资未调整。
比利时医院外科患者的老年护理主要是反应性的，尽管老年病医生更倾向于更主动的服务。改善的主要机会和挑战是解决老年病工作领域的人员短缺问题，并更新立法和融资。
