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Are older patients at high risk of adverse health outcomes identified in hospital?

Are older patients at high risk of adverse health outcomes identified in hospital?
Are older patients at high risk of adverse health outcomes identified in hospital?
Introduction: Older people represent nearly two-third of admissions to hospitals in the UK, and many are at high risk of poor healthcare outcomes including long length of stay and admission to care homes. Early identification of these patients would allow appropriate interventions to improve outcomes. It is unclear whether and how they are identified within current practice. The aim of this study was to define current practice with regard to the identification of older patients at high risk of poor healthcare outcomes.

Methods: A random sample of 60 patients’ clinical records from five geriatric wards in one hospital were reviewed for evidence of risk assessments occurring routinely on admission. In addition, semi-structured interviews/focus groups were conducted with 22 healthcare staff across the study wards including: 7 nursing staff, 4 dieticians, 7 medical staff, and 4 therapists.

Results: A number of risk-assessments take place routinely early on admission including, assessment of nutrition using Malnutrition Universal Screening Test (MUST) score (85% patients), recognition of dementia and delirium using (77%), risk of falls (95%), moving and handling assessment (85%), and pressure ulcers assessment (88%). However, there was no explicit tool to identify older patients at risk of poor healthcare outcomes. Qualitative data revealed that healthcare staff depend on “clinical judgement” to recognise high-risk patients based on detailed collateral history about patient’s general condition, reasons for admission, ability to manage at home and level of care needed, number of comorbidities, and patient’s engagement with therapy assist professional judgment. Yet, most often making such a judgment occurs several days after admission potentially delaying interventions.

Conclusions: Although a number of risk assessments are used routinely on admission to geriatric wards, explicit identification of patients at risk of poor healthcare outcomes is missing. Staff rely on clinical judgement which often occurs later on admission potentially delaying interventions.
0002-0729
i35-i38
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Owen, Charlotte
970660f9-538f-44b5-8595-e262cc717086
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Patel, Harnish
514aba46-4dc9-4011-b393-ce83c6206754
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Owen, Charlotte
970660f9-538f-44b5-8595-e262cc717086
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Patel, Harnish
514aba46-4dc9-4011-b393-ce83c6206754
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253

Ibrahim, Kinda, Owen, Charlotte, Barker, Mary, Patel, Harnish, Aihie Sayer, Avan and Roberts, Helen (2017) Are older patients at high risk of adverse health outcomes identified in hospital? Age and Ageing, 46 (Suppl_1), i35-i38, [141]. (doi:10.1093/ageing/afx068.141).

Record type: Meeting abstract

Abstract

Introduction: Older people represent nearly two-third of admissions to hospitals in the UK, and many are at high risk of poor healthcare outcomes including long length of stay and admission to care homes. Early identification of these patients would allow appropriate interventions to improve outcomes. It is unclear whether and how they are identified within current practice. The aim of this study was to define current practice with regard to the identification of older patients at high risk of poor healthcare outcomes.

Methods: A random sample of 60 patients’ clinical records from five geriatric wards in one hospital were reviewed for evidence of risk assessments occurring routinely on admission. In addition, semi-structured interviews/focus groups were conducted with 22 healthcare staff across the study wards including: 7 nursing staff, 4 dieticians, 7 medical staff, and 4 therapists.

Results: A number of risk-assessments take place routinely early on admission including, assessment of nutrition using Malnutrition Universal Screening Test (MUST) score (85% patients), recognition of dementia and delirium using (77%), risk of falls (95%), moving and handling assessment (85%), and pressure ulcers assessment (88%). However, there was no explicit tool to identify older patients at risk of poor healthcare outcomes. Qualitative data revealed that healthcare staff depend on “clinical judgement” to recognise high-risk patients based on detailed collateral history about patient’s general condition, reasons for admission, ability to manage at home and level of care needed, number of comorbidities, and patient’s engagement with therapy assist professional judgment. Yet, most often making such a judgment occurs several days after admission potentially delaying interventions.

Conclusions: Although a number of risk assessments are used routinely on admission to geriatric wards, explicit identification of patients at risk of poor healthcare outcomes is missing. Staff rely on clinical judgement which often occurs later on admission potentially delaying interventions.

Full text not available from this repository.

More information

Accepted/In Press date: 10 March 2017
e-pub ahead of print date: 16 May 2017

Identifiers

Local EPrints ID: 412292
URI: http://eprints.soton.ac.uk/id/eprint/412292
ISSN: 0002-0729
PURE UUID: 95034a68-090f-42f1-9088-e5ffa1564e57
ORCID for Kinda Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for Helen Roberts: ORCID iD orcid.org/0000-0002-5291-1880

Catalogue record

Date deposited: 17 Jul 2017 13:26
Last modified: 07 Oct 2020 02:04

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