scholarly journals 216 Integrated Day Hospital for Older Persons in a Primary Care Centre

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Fiona McGrath ◽  
Sarah Ronayne ◽  
Karen McHugh ◽  
Mary McDonnell ◽  
Elnsari Muataz ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Older Persons ◽  
Blood Pressure Monitoring ◽  
Rapid Assessment ◽  
Population Data ◽  
Shared Vision ◽  
Primary Care Centre ◽  
Day Hospital ◽  
Care Centre

Abstract Background To progress with integrated care, for older persons, it was proposed to establish a Day Hospital in a Primary Care Centre. Population data for Co Mayo shows the percentage of those over 65 years, (17.6%), to be significantly higher than the national average In 2018 there were 39,092 attendances to the Emergency Department and approximately 500, per month, were over 75 years. The aim was to develop a pathway from the Emergency Department to the Day Hospital for those 75 years and over who had experienced a fall. Additionally, this included an Early Supported Discharge for hip fracture patients. Methods The Day Hospital was operational 1 day per week with an allocation of funding for a Consultant, Occupational Therapist and assigned Project Manager. Holter and Blood pressure monitoring equipment was purchased. The Home First Team were reassigned to the front door of the hospital and worked with a cANP and a Medical Registrar. A weekly multi-disciplinary forum, inclusive of all stakeholders, developed working relationships, built a shared vision and standardised the approach for the patient cohort. Frailty training was provided specifically to Emergency Department staff. Results The Home First Team saw 541 patients (Jan-Apr 2019) and in collaboration with the Geriatrician streamed those suitable for management to primary care. The Integrated Day Hospital, 1 day per week (Jan-Apr 2019) delivered 55 new assessments plus follow-up appointments. Patient feedback is very positive and specifically highlights ease of access in primary care. Conclusion Establishing a Day Hospital in a Primary Care Centre is an innovative approach and shifts the focus of intervention from acute to primary care. The location is ideal due to a range of disciplines on site, PHN, Dietetics, Psychiatry This is the initial phase, with some pathways in place, and the overall aim is to provide GP access to rapid assessment in Primary Care and thus ensure hospital avoidance where possible.

scholarly journals Nursing Fundamentals: Light between the Shadows of Covid-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
Mercedes De Dios Aguado ◽  
Keyword(s):  
Primary Care ◽  
Nursing Staff ◽  
Primary Care Centre ◽  
Care Centre ◽  
Florence Nightingale

The main objective of this article is to share the experienceof nursing staff during the COVID 19 pandemic in a Primary Care Centre of the Toledo province the care and attention given to population follow the foundations of the nursing theories Florence Nightingale, Concepción Arenal and Hildegard Peplau.

scholarly journals 211 A Novel Integrated Care Approach: Supporting Older Persons to Remain at Home

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Sarah Tormey ◽  
Laura Binions ◽  
Aoife Dunne ◽  
Josephine Soh ◽  
Marie O'Connor ◽  
...  
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Older Persons ◽  
Care Team ◽  
Resource Utilisation ◽  
Day Hospital ◽  
Clinical Frailty Scale ◽  
Integrated Network ◽  
Rapid Access ◽  
Co Morbidity

Abstract Background An Integrated Care Team (ICT) was established within our Day Hospital in September 2018 serving a catchment of older persons encompassing 3 Community Healthcare Organisations. The geographical spread of our patients poses challenges to the ICT in establishing an integrated network of services for patients. Provided here is a descriptive analysis of our patient cohort including basic demographics, co-morbidities, interventions and outcomes. Methods The team comprises of a Senior Physiotherapist, Occupational Therapist and Medical Social Worker supported by two Geriatricians. Referrals to the ICT are via the Day Hospital with a weekly multi-disciplinary team (MDT) meeting where they are discussed and prioritised. Interventions offered include domiciliary and day hospital based assessments. Following assessment appropriate targeted therapeutic intervention is provided which includes rapid access to enabling equipment, access to community supports and rapid access Geriatrician review. Additionally the ICT communicate with the acute and primary care services to identify existing or previous resource utilisation. Results In the inaugural 15 weeks of the service,132 referrals were received. This cohort had a mean age of 81,range (60-102) years; 58% female, 42%male. The Charlson Co-morbidity Index (CCI) score ranged from 2-9 with a mean score of 5. Of these, 50% had a Dementia diagnosis, 33% had a Falls history and 17% had a Stroke diagnosis. The mean Rockwood Clinical Frailty Scale score was 5; range ( 2-7). 62% of referrals were reviewed by both Physiotherapy and Occupational therapy, 58% by Medical Social Work. 34/132 required input from all 3 disciplines. Conclusion The ICT service has augmented the existing Day Hospital with timely multi-disciplinary assessment and treatment enabling older persons’ independence within their home in addition to forward planning if dependency levels increase. Additional benefits include reduction of primary care team waiting lists and forging links with our community and local rehab services. Future ambitions include recruitment of specialist nursing and direct referral pathways from our community colleagues.

scholarly journals Vitamin D levels in a pediatric population of a primary care centre: a public health problem?

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
J. M. Fernández Bustillo ◽  
A. Fernández Pombo ◽  
R. Gómez Bahamonde ◽  
E. Sanmartín López ◽  
O. Gualillo
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Vitamin D ◽  
Health Problem ◽  
Pediatric Population ◽  
Public Health Problem ◽  
Primary Care Centre ◽  
Care Centre ◽  
Vitamin D Levels
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