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预防住院老年患者在医疗病房中出现功能下降:最佳实践实施项目。

Preventing functional decline in hospitalized older adults in medical ward: a best practice implementation project.

机构信息

College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

JBI Evid Implement. 2024 Aug 1;22(3):271-280. doi: 10.1097/XEB.0000000000000411.

Abstract

INTRODUCTION AND OBJECTIVES

Functional decline frequently occurs in older adults in hospitals. The aim of this project was to promote evidence-based strategies for physical activity to prevent functional decline in hospitalized older adults in a medical center in southern Taiwan.

METHODS

This project was guided by the JBI Evidence Implementation Framework. Seven audit criteria were derived from a JBI evidence summary and a baseline audit involving 25 nurses and 30 hospitalized older adults was conducted to compare current practice with best practice recommendations. The JBI Getting Research into Practice (GRiP) approach was used to identify barriers to implementation, and strategies were developed to overcome those barriers. A follow-up audit was conducted to measure any changes in compliance.

RESULTS

After implementing the strategies, the pass rate of nursing staff improved in the physical activity knowledge test, rising from 56% to 88%. Compliance of nursing staff with providing physical activity instructions using evidence-based guidelines to hospitalized older adults reached 80%. The incidence of functional decline among hospitalized older adults decreased from 36.7% to 20%.

CONCLUSIONS

The results of this best practice implementation project suggest that initiating physical activity as early as possible for hospitalized older adults once their medical condition has stabilized can help prevent functional decline.

SPANISH ABSTRACT

http://links.lww.com/IJEBH/A171.

摘要

目的

功能衰退在医院中的老年人中经常发生。本项目旨在促进基于证据的身体活动策略,以预防中国台湾南部某医学中心住院老年人的功能衰退。

方法

本项目以 JBI 循证实施框架为指导。从 JBI 证据总结和基线审核中得出了 7 项审核标准,涉及 25 名护士和 30 名住院老年人,以比较当前实践与最佳实践建议。采用 JBI 将研究转化为实践(GRiP)方法识别实施障碍,并制定策略克服这些障碍。进行后续审核以衡量合规性的任何变化。

结果

实施策略后,护理人员的身体活动知识测试通过率从 56%提高到 88%。护理人员根据循证指南为住院老年人提供身体活动指导的合规性达到 80%。住院老年人的功能衰退发生率从 36.7%下降到 20%。

结论

本最佳实践实施项目的结果表明,一旦住院老年人的病情稳定,尽早开始身体活动有助于预防功能衰退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f76/11323752/1efa6da9062b/jbeim-22-271-g001.jpg

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