Changes of geriatric syndromes in older adults survived from Intensive Care Unit

Tang, Hung Jen; Tang, Hsin-Yi Jean; Hu, Fang‐Wen; Chen, Ching-Huey

doi:10.1016/j.gerinurse.2016.10.011

Cited by 21 publications

(26 citation statements)

References 34 publications

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“…-Return to the home of previously hospitalized elderly people with acquired UI (4)(5)(6)8,13,(16)(17)20) .…”

Section: Resultsmentioning

confidence: 99%

“…-Non-recognition of the problem, resulting in lack of actions to promote continence and prevention of UI by the care team (7,13,(15)(16)(17)(18)20) . -Deficit of professional knowledge and misconceptions about UI in the elderly (4,7,(16)(17)(18) .…”

Section: Processmentioning

confidence: 99%

“…In order for the nurses and the multidisciplinary team to systematically identify the UI and start their management in the long term, some measures can be taken, among them the training of the team, alerting them about the condition, and the risks of developing it (17)(18)(19) . In addition, in order to improve UI recognition, the screening of affected individuals should be performed through the nursing history, with an item on the urination added to the instrument, and if those with UI wish to improve this situation (14,16,18) .…”

Section: Deficit In Screening Identification Of Risk and Underreportmentioning

confidence: 99%

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Hospital care and urinary incontinence in the elderly

et al. 2019

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Objective: to identify factors inherent in hospital care that favor urinary incontinence in the elderly. Method: an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model. Results: 13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly. Conclusion: modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.

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“…-Return to the home of previously hospitalized elderly people with acquired UI (4)(5)(6)8,13,(16)(17)20) .…”

Section: Resultsmentioning

confidence: 99%

Section: Processmentioning

confidence: 99%

Section: Deficit In Screening Identification Of Risk and Underreportmentioning

confidence: 99%

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Hospital care and urinary incontinence in the elderly

et al. 2019

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“…The elderly population receiving home care are a frail group of individuals with complex diseases and needs for comprehensive health care [4][5][6]. When frail elderly persons become acutely ill, the symptoms are often nonspecific, with an atypical presentation that combines physical, psychological, social and functional manifestations [7][8][9][10][11]. In Norway and in this paper, this group of symptoms is referred to as 'acute functional decline'.…”

Section: Acute Functional Declinementioning

confidence: 99%

“…In Norway and in this paper, this group of symptoms is referred to as 'acute functional decline'. Internationally, the term 'geriatric syndrome' is often used to describe the same condition, and there is a lack of consensus on the definition of the condition [8,9].…”

Section: Acute Functional Declinementioning

confidence: 99%

Applying the Modified Early Warning Score (MEWS) to assess geriatric patients in home care settings: A qualitative study of nurses’ and general practitioners’ experiences

Jeppestøl¹,

Kirkevold

Bragstad

2020

Preprint

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Background: Acute functional decline is a common clinical syndrome in geriatric health care that is typically characterised by nonspecific symptoms and presents with a mix of physical, psychological, social and functional manifestations.Early warning score (EWS) systems are widely implemented in nursing homes and home care to detect clinical deterioration. The effects of EWS systems have been thoroughly evaluated in hospital care settings, but few studies have evaluated these systems in community health care.The purpose of this study is to describe the experiences of registered nurses (RNs) and general practitioners (GPs) when using the Modified Early Warning Score (MEWS) to support clinical reasoning and decision-making with geriatric home care patients who suffer from acute functional decline.Method: A qualitative methodology was used with a descriptive exploratory design. Data were collected from seven focus group interviews. GPs and RNs were purposively sampled from large, medium and small municipalities in Norway. Data were analysed using an inductive content analysis method.Results: MEWS was used as an additional decision-making tool with elderly home care patients when acute functional decline was detected. RNs and GPs emphasised that MEWS supported the clinical reasoning and decision-making process. Additionally, those applying MEWS required comprehensive reasoning skills and specific knowledge of the patients. RNs identified the need for contextual adjustments to the use of MEWS in home care settings. Implementing MEWS has improved the collaboration and clinical practice of RNs and GPs. The adherence to MEWS follow-up recommendations was adjusted to the home care setting, accounting for potentially limited medical availability.Conclusion: MEWS supported RNs and GPs in conducting comprehensive clinical assessments and reasoning when acute functional decline was detected. Interdisciplinary communication and collaboration appeared to be strengthened, and GPs’ work was streamlined. Several limitations were identified with the use of MEWS reference values with geriatric patients, which could lead to ambiguity and misjudgements. MEWS trigger recommendations were experienced as inappropriate in the home care context. This study identifies the need for a modified, evidence-based EWS adjusted for geriatric patients in home care.

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Early warning scores and trigger recommendations must be used with care in older home nursing care patients: Results from an observational study

2023

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Despite radically different contexts, early warning score (EWS) tools are recommended in both hospital and community care settings to detect early clinical deterioration and to support clinical decisions in cases of clinical deterioration (NICE, 2007; The Norwegian Directorate of Health, 2020). The implementation of various EWS in home nursing care, care homes and skilled nursing homes is ongoing, and research exploring how EWSs are used and how they impact clinical practice is increasing (

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Changes of geriatric syndromes in older adults survived from Intensive Care Unit

Cited by 21 publications

References 34 publications

Hospital care and urinary incontinence in the elderly

Hospital care and urinary incontinence in the elderly

Applying the Modified Early Warning Score (MEWS) to assess geriatric patients in home care settings: A qualitative study of nurses’ and general practitioners’ experiences

Early warning scores and trigger recommendations must be used with care in older home nursing care patients: Results from an observational study

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