Cefalu C A, Colbourne G, Duffy M, Johnson E, Lestter M, Wright J
UDepartment of Family Medicine/Providence Hospital, Georgetown University School of Medicine, Colmar Manor, MD 20722, USA.
J Am Geriatr Soc. 1997 Mar;45(3):355-60. doi: 10.1111/j.1532-5415.1997.tb00953.x.
To demonstrate an unusual form of inpatient geriatric assessment with unique outcomes.
A prospective evaluation of patients admitted to a community hospital-based inpatient geriatrics unit utilizing traditional members of the assessment team along with educational assessment of nurses and satisfaction profiles of patients and/or families.
A non-profit community hospital in Northeast Washington, DC.
All patients older than age 62 admitted to the 42-bed Geriatric Unit during a 4 1/2 year time period.
Number of total and category recommendations taken by attending physicians from the Inpatient Geriatric Assessment Team, periodic evaluation of unit nurses' geriatric knowledge base and certification, and patient satisfaction through periodic surveys.
More than 4500 patients have been evaluated during the past 4 1/2 years. The number of recommendations taken by attending physicians has averaged 31.3 to 50.7% during four consecutive chart reviews involving the first 25 consecutive patients for the month each performed every six months (n = 100). The average age of patients evaluated was 77.2 (minimum of 62 and maximum of 97); 67% were females and 33% males. The average number of recommendations communicated per patient was 4.1, and the average number adhered to 1.6/patient. The overall knowledge base and certification in geriatric nursing has increased significantly over a 2.5-year period. Composite monthly unit patient satisfaction survey scores increased as well.
The program is unique in its development, limitations, and outcomes. Other than the cost of limited geriatric nurse practitioner and faculty salary support, the program has been implemented using only current hospital department personnel. The role of the assessment team is to educate attending nurses and staff physicians. It has not yet been possible to measure objective outcomes. However, the current program also serves the purpose of introducing a new medical program to a community hospital in a nonthreatening way and offers opportunities for research. In addition, the program offers further opportunity for expansion and change.
展示一种具有独特结果的非传统住院老年评估形式。
对一家社区医院住院老年科收治的患者进行前瞻性评估，评估团队由传统成员组成，同时对护士进行教育评估，并收集患者和/或家属的满意度数据。
华盛顿特区东北部的一家非营利性社区医院。
在4年半时间内入住拥有42张床位老年科的所有62岁以上患者。
主治医生采纳的住院老年评估团队给出的总体及各类建议数量、对科室护士老年知识库及资质认证的定期评估、通过定期调查得出的患者满意度。
在过去4年半里，超过4500名患者接受了评估。在每六个月进行一次的连续四次病历审查中（每次审查当月连续的前25名患者，共100例），主治医生采纳的建议数量平均为31.3%至50.7%。接受评估患者的平均年龄为77.2岁（最小62岁，最大97岁）；67%为女性，33%为男性。每位患者平均收到的建议数量为4.1条，平均采纳数量为每位患者1.6条。在2.5年期间，老年护理的总体知识库及资质认证显著提高。每月综合科室患者满意度调查得分也有所提高。
该项目在其发展、局限性和结果方面独具特色。除了有限的老年护理执业医师和教员薪资支持成本外，该项目仅利用医院现有科室人员实施。评估团队的作用是对主治护士和内科医生进行培训。目前尚无法衡量客观结果。然而，当前项目还起到了以无威胁方式向社区医院引入新医疗项目的作用，并提供了研究机会。此外，该项目还提供了进一步扩展和变革的机会。
