Clinical Changes in Older Adults During Hospitalization: Responsiveness of the interRAI Acute Care Instrument

2013 ◽  
Vol 61 (5) ◽  
pp. 799-804 ◽  
Author(s):  
Nathalie I. H. Wellens ◽  
Geert Verbeke ◽  
Johan Flamaing ◽  
Philip Moons ◽  
Steven Boonen ◽  
...  
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Interrai Acute Care ◽  
Clinical Changes

InterRAI Acute Care Instrument for Seniors in Canadian Hospitals: Findings of an Inter-Rater Reliability Pilot Study

2020 ◽  
pp. 084456212092051
Author(s):  
Veronique Boscart ◽  
Linda Sheiban Taucar ◽  
Michelle Heyer ◽  
Tabitha Kellendonk ◽  
Keia Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Adverse Outcomes ◽  
Cohen’S Kappa ◽  
Nursing Assessment ◽  
Kappa Score ◽  
Rater Reliability ◽  
Cohen's Kappa ◽  
Interrai Acute Care ◽  
Hospitalized Older Adults

Background Older adults are the biggest users of emergency departments and hospitals. However, healthcare professionals are often ill equipped to conduct comprehensive geriatric assessments causing missed opportunities for preventing adverse outcomes. Purpose To evaluate the inter-rater reliability of the interRAI Acute Care (AC) instrument for hospitalized older adults in two acute care hospitals in Ontario, Canada. Methods This descriptive study focused on evaluating the interRAI AC instrument, which was designed to facilitate a comprehensive nursing assessment for hospitalized seniors. Sample characteristics were described, and Cohen’s Kappa was calculated to derive the inter-rater reliability. Assessment times to complete the instrument were collected as well. Results The Cohen’s Kappa score for the instrument was 0.96. Many older adults who were interviewed had several challenges, including multimorbidity, polypharmacy, and lack of home support. The average time required for nurses to complete the interRAI AC instrument was 22 min. Conclusions The interRAI AC instrument is reliable for use by trained nurses to conduct a comprehensive assessment. This instrument offers a standardized and efficient approach to assess for care and intervention priorities and could prevent adverse outcomes in hospitalized older adults.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

Acute care utilization risk among older adults living undiagnosed or unaware of dementia

2021 ◽  
Author(s):  
Halima Amjad ◽  
Quincy M. Samus ◽  
Jin Huang ◽  
Sneha Gundavarpu ◽  
Julie P. W. Bynum ◽  
...  
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Care Utilization ◽  
Acute Care Utilization

scholarly journals The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care

CJEM ◽  
2015 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Judah Goldstein ◽  
Jennifer McVey ◽  
Stacy Ackroyd-Stolarz
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Emergency Medical Services ◽  
Acute Care ◽  
Functional Independence ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Care Needs ◽  
Frail Older Adults ◽  
Emergency Medical

AbstractCaring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

scholarly journals Reliability of an Online Geriatric Assessment Procedure Using the interRAI Acute Care Assessment System

2017 ◽  
Vol 65 (9) ◽  
pp. 2029-2036 ◽  
Author(s):  
Melinda G. Martin-Khan ◽  
Helen Edwards ◽  
Richard Wootton ◽  
Steven R. Counsell ◽  
Paul Varghese ◽  
...  
Keyword(s):  
Acute Care ◽  
Geriatric Assessment ◽  
Assessment System ◽  
Assessment Procedure ◽  
Interrai Acute Care ◽  
Care Assessment

Post‐Acute Care among Older Adults with Stage I to III Colorectal Cancer

2018 ◽  
Vol 67 (5) ◽  
pp. 937-944 ◽  
Author(s):  
Kelly M. Kenzik ◽  
Grant R. Williams ◽  
Smita Bhatia ◽  
Courtney J. Balentine
Keyword(s):  
Colorectal Cancer ◽  
Older Adults ◽  
Acute Care ◽  
Stage I ◽  
Post Acute Care

scholarly journals Barriers and Facilitators for Screening Older Adults on Fall Risk in a Hospital Setting: Perspectives from Patients and Healthcare Professionals

2020 ◽  
Vol 17 (5) ◽  
pp. 1461
Author(s):  
Lotte M. Barmentloo ◽  
Manon L. Dontje ◽  
Moniek Y. Koopman ◽  
Branko F. Olij ◽  
Christian Oudshoorn ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthcare Worker ◽  
Acute Care ◽  
Fall Risk ◽  
Chronic Care ◽  
Healthcare Professionals ◽  
Assessment Instrument ◽  
Barriers And Facilitators ◽  
Worker Characteristics ◽  
Program Characteristics

We aimed to gain insight into the barriers and facilitators to fall risk screening of older adults visiting the hospital as experienced by patients and healthcare professionals, and to examine the differences between chronic- and acute-care patients. We invited patients (≥ 70 years) attending the nephrology and emergency department to participate in the screening. Patients and their healthcare professionals were asked to complete a self-administered questionnaire based on the “Barriers and Facilitators Assessment Instrument”. Differences in barriers and facilitators between acute- and chronic-care patients were examined with chi-square tests. A total of 216 patients were screened, and 103 completed the questionnaire. They considered many factors as facilitators, and none as barriers. Acute-care patients were more positive than chronic-care patients about healthcare worker characteristics, such as knowledge and skills. After screening, patients were more open to receiving advice regarding fall prevention. The 36 healthcare professionals considered program characteristics to be facilitators and mainly factors regarding healthcare worker characteristics as barriers to implementation. For patients, the outpatient setting seemed to be a good place to be screened for fall risk. Healthcare professionals also suggested that program characteristics could enhance implementation. However, healthcare professionals’ mindsets and the changing of routines are barriers that have to be addressed first.

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