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GERIATRIC MODEL Acute Care for Elder (ACE) (CARE OF domainhttps…
GERIATRIC MODEL
Acute Care for Elder (ACE)
Improved Knowledge, Skills, and Attitude
Link Title
CARE OF domain
https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.12282
2.Function-focused care /early rehabilitation
Prevention and Treatment
Evidence-based geriatric screening
3.Discharge planning
1.Frequent medical review
INTEGRATED CARE
Tackle the challenges in continuity and coordination of care
4.Patient-Family-centric care :INITIATED WITHIN 24 HOURS OF ADMISSION AND CONTINUED AT LEAST DAILY
predominatly nursing interventions for preventing declines in physical, cognitive, and psychosocial status
Assessment and Delivery of interventions
The intervention focused on preserving or preventing declines in 6 main areas of functioning
MOBILITY:3 times a day
HYDRATION AND NUTRITIONAL STATUS
COGNITION
encouraging families to visit, promote sleep
SELF-CARE ABILITY
CONTINENCE OF ELIMINATION
SKIN INTEGRITY
Prepared environment
BARRIERS
Workforce issues
Threaten continuity of care after D/C, transfer
Hospital Elder Life Program (HELP)
socialization through physical environmental modifications
Communal rooms?
Iatrogenic Complication
DELIRIUM during hospitalization
FUNCTIONAL DECLINE
Hospital-acquired infections
Deconditioning
[FALLS]50% of falls in the geriatric wards were related to delirium, resulting in an even longer ALOS of 23.9 (Chong et al., 2011)
PRESSURE ULCERS
MALNUTRITION
INCONTINENCE
ADVERSE EFFECTS
In-hospital mortality
READMISSION TO HOSPITAL
Length of hospital stay
PROTOCOL
Functional assessment to ensure early detection of declining performance
MAKE SURE DOCUMENT THE EFFECT OF ON THE FUNCTIONAL PERFORMANCE OF THE PATIENT
Ensure the rehabilitation process doesn't get interrupted after discharge home or transfer to other facilities.
Mobilization and Physical activity initiated by the nurses and PTs
insufficient functional improvement
disease exacerbation
NEW!!
Add a nursing discharge summary
reinforce Clutter free rooms
encourage families to get involve in recovering cognitive function by visiting the patients/continuing social interaction.
MEASUREMENTS: falls, pressure ulcers, delirium, functional decline, length of hospital stay, discharge destination(home or nursing home), and costs.