scholarly journals Creative Music Therapy in an Acute Care Setting for Older Patients with Delirium and Dementia

2016 ◽  
Vol 6 (2) ◽  
pp. 268-275 ◽  
Author(s):  
Chin Yee Cheong ◽  
Jane An Qi Tan ◽  
Yi-Lin Foong ◽  
Hui Mien Koh ◽  
Denise Zhen Yue Chen ◽  
...  
Keyword(s):  
Music Therapy ◽  
Acute Care ◽  
Older Patients ◽  
Care Setting ◽  
Rating Scale ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Acute Care Setting ◽  
Creative Music ◽  
The Impact

Background/Aims: The acute hospital ward can be unfamiliar and stressful for older patients with impaired cognition, rendering them prone to agitation and resistive to care. Extant literature shows that music therapy can enhance engagement and mood, thereby ameliorating agitated behaviours. This pilot study evaluates the impact of a creative music therapy (CMT) programme on mood and engagement in older patients with delirium and/or dementia (PtDD) in an acute care setting. We hypothesize that CMT improves engagement and pleasure in these patients. Methods: Twenty-five PtDD (age 86.5 ± 5.7 years, MMSE 6/30 ± 5.4) were observed for 90 min (30 min before, 30 min during, and 30 min after music therapy) on 3 consecutive days: day 1 (control condition without music) and days 2 and 3 (with CMT). Music interventions included music improvisation such as spontaneous music making and playing familiar songs of patient's choice. The main outcome measures were mood and engagement assessed with the Menorah Park Engagement Scale (MPES) and Observed Emotion Rating Scale (OERS). Results: Wilcoxon signed-rank test showed a statistically significant positive change in constructive and passive engagement (Z = 3.383, p = 0.01) in MPES and pleasure and general alertness (Z = 3.188,p = 0.01) in OERS during CMT. The average pleasure ratings of days 2 and 3 were higher than those of day 1 (Z = 2.466, p = 0.014). Negative engagement (Z = 2.582, p = 0.01) and affect (Z = 2.004, p = 0.045) were both lower during CMT compared to no music. Conclusion: These results suggest that CMT holds much promise to improve mood and engagement of PtDD in an acute hospital setting. CMT can also be scheduled into the patients' daily routines or incorporated into other areas of care to increase patient compliance and cooperation.

Abstract P301: Evaluating the Impact of a Pharmacist-Managed Hypertension Collaborative Care Model in Vascular Neurology Patients in an Inpatient Acute Care Setting

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ann Smith ◽  
Kathleen Bledsoe ◽  
Thomas Madden ◽  
Jamie Artale ◽  
Ted Sindlinger
Keyword(s):  
Blood Pressure ◽  
Acute Care ◽  
Care Setting ◽  
Management Practice ◽  
Primary Objective ◽  
Adverse Outcomes ◽  
Acute Care Setting ◽  
Percentage Reduction ◽  
Improvement Project ◽  
The Impact

Introduction: The utility of pharmacist-managed collaborative practice agreements (CPA) in the management of hypertension is well established in the outpatient setting. There has been little evaluation of the use of CPAs in the inpatient acute care setting, and none described specifically in the vascular neurology population. Treatment of hypertension is a critical intervention for the secondary prevention of acute ischemic stroke. This quality improvement project evaluated the implementation of a CPA for the inpatient acute care management of hypertension in vascular neurology patients at University of Virginia Health. Methods: A CPA was developed between the neurosciences clinical pharmacist group and the inpatient vascular neurology service, legally vetted, and implemented in June 2019. All vascular neurology patient charts in which an electronic CPA referral was placed from June 2019 through June 2020 were reviewed. Patients were excluded if they were discharged within 24 hours of the referral being placed. The primary objective was to describe and evaluate the implementation of a pharmacist-driven hypertension management practice in the inpatient acute care setting. All patient demographic and clinical data were analyzed using descriptive statistics. Secondary safety outcomes included documented hypotensive events (SBP <90) and acute kidney injury (AKI, increase in SCr by 0.3 mg/dl within 48 hours). Results: During the study period, 26 referrals were placed, and 19 patients were included for review. On average, patients were on 2 anti-hypertensive medications prior to admission. From the time of referral to discharge (mean 6 days), systolic blood pressure (SBP) was reduced on average by 36 mmHg (mean percentage reduction 20%) and diastolic blood pressure (DBP) by 12 mmHg (mean percentage reduction 7%). Ten patients (53%) met the goal of SBP < 140 at discharge. There were 5 hypotensive events and 4 instances of AKI, all of which were mild and recovered prior to discharge. Conclusion: A pharmacist-managed hypertension CPA was successfully implemented in vascular neurology patients in the inpatient acute care setting. The practice demonstrated improved blood pressure control and minimal adverse outcomes.

What factors affect nursing retention in the acute care setting?

2011 ◽  
Vol 16 (6) ◽  
pp. 489-500 ◽  
Author(s):  
Cynthia L. Cummings
Keyword(s):  
Acute Care ◽  
Care Setting ◽  
Moral Distress ◽  
Intent To Stay ◽  
Institutional Setting ◽  
Acute Care Setting ◽  
Nursing Retention ◽  
Acute Care Nurses ◽  
Professional Stress ◽  
The Impact

Moral distress and professional stress affect the lives of acute care nurses everyday. The impact of these stressors may be causing nurses to leave the acute care setting. This paper will outline the findings from a descriptive study of acute care nurses in Northeast Florida. The research was conducted in an effort to highlight some of the critical factors that impact nurses in the acute care setting and affect their intent to stay at an institution. The concepts of moral distress and professional stress in relation to nursing retention are highlighted and some strategies for lessening of these stressors are proposed. The study was correlational and conducted among 234 nurses in an institutional setting. The study included an online survey based on established Moral Distress and Professional Stress tools. In addition, a qualitative section was included to explore the nurses’ experiences of stressful inpatient situations. The results of this study demonstrated that when combined, both professional stress and moral distress items were predictive of the nurses’ intent to stay at the institution ( p <.001).

The Impact of Intrainstitutional Relocation on Morbidity in an Acute Care Setting

1995 ◽  
Vol 35 (2) ◽  
pp. 217-224 ◽  
Author(s):  
J. Mirotznik ◽  
T. G. Lombardi
Keyword(s):  
Acute Care ◽  
Care Setting ◽  
Acute Care Setting ◽  
The Impact

Using a Nursing Minimum Data Set with older patients with dementia in an acute care setting

2004 ◽  
Vol 47 (3) ◽  
pp. 329-339 ◽  
Author(s):  
Myonghwa Park ◽  
Connie Delaney ◽  
Meridean Maas ◽  
David Reed
Keyword(s):  
Acute Care ◽  
Older Patients ◽  
Care Setting ◽  
Minimum Data Set ◽  
Acute Care Setting ◽  
Data Set ◽  
Minimum Data

scholarly journals 135 The Impact of an Early Mobilisation Initiative Evidence from an Acute Care Setting

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Aileen Horgan ◽  
Michelle Carr ◽  
Aileen Murphy
Keyword(s):  
Acute Care ◽  
Patient Outcomes ◽  
Care Setting ◽  
Functional Decline ◽  
Length Of Hospital Stay ◽  
Hospital Length Of Stay ◽  
Acute Care Setting ◽  
Early Mobilisation ◽  
The Impact ◽  
Improve Patient

Abstract Background Unnecessary bed rest results in a loss of mobility and an increased length of hospital stay. Despite mobilising regularly being acknowledged as an important preventative measure for deconditioning, inpatient functional decline continues to pose a significant challenge in hospital settings. Hospital-based mobility initiatives offer the potential to address issues of functional decline, improve patient outcomes and hospital length of stay. The aim of this research is to examine the impact of an early mobilisation initiative called “End PJ Paralysis”. Methods The research design comprises of three elements: (i) an examination of a period that promoted mobility to all patients on one acute unit (ii) an analysis of the reported number of falls during the study period and (iii) an exploration of perceptions and attitudes of nurses, nurse managers, and patients involved with the initiative. Results Our study demonstrates that following a 10-week promotion of the initiative from April 17th-June 26th 2018 in an acute care setting in south of Ireland, an increase of 15% of patients were mobilising and a decrease in the number of reported falls. In addition, staff participation was found to increase and self-reported patient satisfaction improved. Factors identified as influencing the impact of the initiative included patient and staff behavior, nurse management leadership, and effective communication. Conclusion The study provides evidence to suggest that early mobilisation initiatives can prevent deconditioning and improve patient outcomes. Each day a patient spends in hospital should contribute towards their recovery and discharge and mobilising patients while in hospital has a profound impact on their functional status.

Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting

2016 ◽  
Vol 35 (1) ◽  
pp. 97-107 ◽  
Author(s):  
Joel G. Anderson ◽  
Mary Ann Friesen ◽  
Diane Swengros ◽  
Anna Herbst ◽  
Lucrezia Mangione
Keyword(s):  
Patient Care ◽  
Registered Nurses ◽  
Acute Care ◽  
Care Setting ◽  
Care Delivery ◽  
Acute Care Setting ◽  
Healing Touch ◽  
The Impact ◽  
Acute Care Nursing ◽  
Care Nursing

Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.

PP163-SUN THE IMPACT OF LENGTH OF STAY ON THE NUTRITIONAL STATUS OF LONG-TERM PATIENTS IN THE ACUTE CARE SETTING

2011 ◽  
Vol 6 (1) ◽  
pp. 85-86
Author(s):  
J. Bauer ◽  
K. Hiscocks ◽  
R. Fichera ◽  
P. Horsley ◽  
J. Martineau ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Nutritional Status ◽  
Acute Care ◽  
Care Setting ◽  
Acute Care Setting ◽  
The Impact
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