Age and ageing最新文献

筛选
英文 中文
Core outcome set for studies evaluating interventions to prevent or treat delirium in long-term care older residents: international key stakeholder informed consensus study. 评估长期护理老年居民谵妄预防或治疗干预措施研究的核心结果集:国际主要利益相关者知情共识研究。
IF 6 2区 医学
Age and ageing Pub Date : 2024-10-01 DOI: 10.1093/ageing/afae227
Gregor Russell, Namrata Rana, Siobhan T Reilly, Anas Shehadeh, Valerie Page, Najma Siddiqi, Louise Rose
{"title":"Core outcome set for studies evaluating interventions to prevent or treat delirium in long-term care older residents: international key stakeholder informed consensus study.","authors":"Gregor Russell, Namrata Rana, Siobhan T Reilly, Anas Shehadeh, Valerie Page, Najma Siddiqi, Louise Rose","doi":"10.1093/ageing/afae227","DOIUrl":"https://doi.org/10.1093/ageing/afae227","url":null,"abstract":"<p><strong>Background: </strong>Trials of interventions to prevent or treat delirium in older adults resident in long-term care settings (LTC) report heterogenous outcomes, hampering the identification of effective management strategies for this important condition. Our objective was to develop international consensus among key stakeholders for a core outcome set (COS) for future trials of interventions to prevent and/or treat delirium in this population.</p><p><strong>Methods: </strong>We used a rigorous COS development process including qualitative interviews with family members and staff with experience of delirium in LTC; a modified two-round Delphi survey; and virtual consensus meetings using nominal group technique. The study was registered with the Core Outcome Measures in Effectiveness Trials (COMET) initiative (https://www.comet-initiative.org/studies/details/796).</p><p><strong>Results: </strong>Item generation identified 22 delirium-specific outcomes and 32 other outcomes from 18 qualitative interviews. When combined with outcomes identified in our earlier systematic review, and following an item reduction step, this gave 43 outcomes that advanced to the formal consensus processes. These involved 169 participants from 12 countries, and included healthcare professionals (121, 72%), researchers (24, 14%), and family members/people with experience of delirium (24, 14%). Six outcomes were identified as essential to include in all trials of interventions for delirium in LTC, and were therefore included in the COS. These are: 'delirium occurrence'; 'delirium related distress'; 'delirium severity'; 'cognition including memory', 'admission to hospital' and 'mortality'.</p><p><strong>Conclusions: </strong>This COS, endorsed by the American Delirium Society and the European and Australasian Delirium Associations, is recommended for use in future clinical trials evaluating delirium prevention or treatment interventions for older adults residing in LTC.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 10","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bone-A-Fide Breakthrough: Machine Learning Cracks the Code on Osteoporosis Treatment Using the Irish Hip Fracture Database 真正的骨骼突破:机器学习利用爱尔兰髋部骨折数据库破解骨质疏松症治疗密码
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.027
Nur Atikah Mohd Asri, Azrin Muslim, Niamh O'Regan, Annette McEliggott
{"title":"Bone-A-Fide Breakthrough: Machine Learning Cracks the Code on Osteoporosis Treatment Using the Irish Hip Fracture Database","authors":"Nur Atikah Mohd Asri, Azrin Muslim, Niamh O'Regan, Annette McEliggott","doi":"10.1093/ageing/afae178.027","DOIUrl":"https://doi.org/10.1093/ageing/afae178.027","url":null,"abstract":"Background Osteoporosis is a metabolic bone disorder characterised by decreased bone mineral density and mass. Due to its asymptomatic nature, it often remains undiagnosed and untreated until a fracture occurs. Traditionally, treatment decisions for osteoporosis are based on clinical appropriateness while balancing the treatment's risks and benefits. Machine learning (ML) is revolutionising healthcare domains through pattern recognition of previously “unseen” observations. Presently, its application in osteoporosis is limited to early diagnosis. More research is needed to examine its role in guiding osteoporosis treatment. This study aims to identify new predictive attributes for osteoporosis treatment using ML techniques on data from the Irish Hip Fracture Database (IHFD). Methods Datasets from January to March 2023 in University Hospital Waterford were sourced from the IHFD. Osteoporosis treatment decisions were obtained from discharge letters. Preliminary data cleaning was performed in Excel with zero-variance and near-zero predictor. Attributes excluded. The dataset was entered into the WEKA 3.8.6 environment for ML processing. Results The initial dataset containing 141 instances and 32 attributes was refined using the Correlation Feature Selection and Ranker Search Method, identifying key osteoporosis treatment predictors. The highest correlation attributes are pre-fracture total score, pre-fracture indoor score, and age. Moderately positive correlations are discharge destination, pre-fracture outdoor and shopping score, ASA grade, Length-of-stay, admission code, Admission 4AT score, Frailty scale, and fracture type. The implemented J48 Tree ML-trained model revealed Correctly Classified Instances and Incorrectly Classified Instances of 98.24% and 1.7%, respectively, indicating a high prediction accuracy rate. Conclusion This study demonstrates the potential of ML in enhancing osteoporosis treatment decision-making by leveraging datasets from the IHFD. Integrating ML algorithms with traditional approaches can provide a comprehensive, nuanced and personal approach to osteoporosis treatment and patient care. The study opens avenues for future research in applying big data and advanced analytics in healthcare, underscoring the evolving landscape of medical decision-making.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"43 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Establishing The Role Of The Clinical Nurse Specialist For The Older Adult In A Model 2 Hospital 在示范二甲医院中确立老年人临床护理专家的角色
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.209
Cliona Woulfe, Patricia Moloney, Emma Jennings
{"title":"Establishing The Role Of The Clinical Nurse Specialist For The Older Adult In A Model 2 Hospital","authors":"Cliona Woulfe, Patricia Moloney, Emma Jennings","doi":"10.1093/ageing/afae178.209","DOIUrl":"https://doi.org/10.1093/ageing/afae178.209","url":null,"abstract":"Background On average 87.5% of inpatients in our Model-2 Hospital are aged sixty-five years or above. Equally 57.5% of inpatients have medium to maximum dependency care needs. In order to meet the needs of this cohort of patients a new post “Clinical Nurse Specialist (CNS) For The Older Adult” was established in September 2023. Methods Using an online referral system, criteria for referral included i) new onset confusion or delirium, ii) clinical frailty score (CFS) of six or greater, iii) known Parkinson’s disease and iv) nursing or medical team clinical judgement. All reviewed patients received a comprehensive geriatric assessment using the Geriatric 5M framework (Mobility, Medications, Multi-Complexities, Mind and Matters Most) ensuring all aspects of patient care were assessed and promoting timely input from our multi-disciplinary team (Physiotherapy, Dietitian, Speech and Language Therapy, Occupational Therapy and Pharmacy). Results Over a period of 207 days the newly established CNS service received a total of 317 referrals. Two thirds (n=206, 65%) received CNS review, one third (n=111, 35%) did not; 45 (14%) were under the care of a consultant Geriatrician and not reviewed to avoid duplication and 66 (21%) were discharged before review could occur. Conclusion Referral numbers received since the established of the CNS post emphasises the need for the service in our hospital inpatient population. Development of the post has ensured that two-in-three referred patients receive a CNS lead CGA. Results from this pilot highlights the need to further develop and expand the service to target the one-in-five who missed review and further extension of the referral criteria.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“The Past is a Foreign Country”: Time Shelter and exploring dementia and memory impairment representation in literature and the arts "往事如烟":时光隧道,探索文学艺术中痴呆症和记忆障碍的表现形式
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.175
Adam Roche, Neasa Fitzpatrick, Iracema Leroi
{"title":"“The Past is a Foreign Country”: Time Shelter and exploring dementia and memory impairment representation in literature and the arts","authors":"Adam Roche, Neasa Fitzpatrick, Iracema Leroi","doi":"10.1093/ageing/afae178.175","DOIUrl":"https://doi.org/10.1093/ageing/afae178.175","url":null,"abstract":"Background Due to ageing populations, the WHO estimates that by 2050 the number of people living with dementia worldwide will more than triple to 152 million. For those working in geriatric medicine and memory services, we regularly interact with and advocate for patients coming to terms with memory impairments. One common theme often encountered during the patient dementia and cognitive impairment diagnosis journey is fear of loss of the sense of “self”, which can be informed by the negative and often inaccurate cultural narrative around dementia. Methods Recent promising breakthroughs in the development of disease modifying medications for Alzheimer’s disease, as well as greater emphasis on lifelong brain health and earlier diagnosis, represents a potential source of hope. This presentation will aim to explore the cultural narrative around the “lived experience” of dementia, which is often extremely negative and emphasises hopelessness. We look to some of the most commonly referenced narrative works, which can often form the foundation of many patient's prior knowledge of cognitive impairment and dementia before coming to the memory clinic. Results This presentation aims to examine the narrative works familiar to many patients (such as “The Father” and “Still Alice”) as well as some more recent efforts, including this year’s International Booker Prize-winning novel “Time Shelter” by Georgi Gospodinov. This darkly humorous book describes the arrival of a strange new ‘clinic for the past’ offering promising treatment for people with dementia. Conclusion Many works of narrative fiction explore dementia and memory impairment. While some are well-informed and researched, many lack empathy or even clinical accuracy. Narrative works can have an enormous impact on the widespread perception and understanding of diseases such as dementia. By exploring the potential for sensitive and accurate representation of dementia in popular culture, we aim to promote equity in this vulnerable and growing population.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"26 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Work of ART: Profiling the First 100 Patients Discharged Home From an Acute Hospital with the Active Recovery Team (ART) ART 的工作:剖析在积极康复团队(ART)的帮助下从急症医院出院回家的前 100 名患者
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.186
Edel McDaid, Ciara Ryan, Eoin Daly
{"title":"Work of ART: Profiling the First 100 Patients Discharged Home From an Acute Hospital with the Active Recovery Team (ART)","authors":"Edel McDaid, Ciara Ryan, Eoin Daly","doi":"10.1093/ageing/afae178.186","DOIUrl":"https://doi.org/10.1093/ageing/afae178.186","url":null,"abstract":"Background The Active Recovery Team (ART) is a new therapy lead rehabilitation team that offers supported discharge and admission avoidance from a large acute hospital. This interdisciplinary team consists of a physiotherapist, occupational therapist, medical social worker and two therapy assistants. ART accepts referrals from all services within the hospital including the emergency department. Methods As ART is a new service, a retrospective audit of the first 100 patients who discharged on the pathway was completed. Demographics included age, sex, referring specialty, presenting complaint, frailty (measured by the Clinical Frailty Score) and level of input received. ART use the coding of low, medium and high intensity to describe the intervention provided based on dosage (visits) and complexity. Results Most (67%) of the group were female and mean age was 77 years. Only 8% were pre-frail (CFS 0-3), 86% were living with mild to moderate frailty (CFS 4-6) and 6% considered severely frail (CFS 7-9). The type of intervention patients received was 31% low, 33% medium and 36% high intensity. Referrals came from a range of specialties, but the highest percentage of referrals were from emergency medicine (29%), medicine (20%), orthopaedics (18%) and geriatric medicine (16%). Most (53%) initially presented post a fall at home. Most frequent reason for ART referral (78%) was that the patient was discharging home not at their functional baseline but had potential to an achieve a specific goal(s) with further input (most frequently within domains of mobility indoors/outdoors, transfers, stairs and activities of daily living). Conclusion This is an effective pathway that improves the transition from hospital to home. ART offer patients an opportunity for further rehabilitation at home with continuity of care from the acute hospital. Future work will examine the impact of ART on length of stay, readmission rate and explore patient satisfaction with this service.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"74 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical, Patient And Service Outcomes For Patients In A Rehabilitation Hospital With An Onsite Flexible Endoscopic Evaluation Of Swallowing Service 一家提供现场灵活内窥镜吞咽评估服务的康复医院的临床、患者和服务成果
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.333
Kara Flaherty, Aideen Lawlor, Laura Douglas
{"title":"Clinical, Patient And Service Outcomes For Patients In A Rehabilitation Hospital With An Onsite Flexible Endoscopic Evaluation Of Swallowing Service","authors":"Kara Flaherty, Aideen Lawlor, Laura Douglas","doi":"10.1093/ageing/afae178.333","DOIUrl":"https://doi.org/10.1093/ageing/afae178.333","url":null,"abstract":"Background Dysphagia has been reported in almost half of hospital patients who are over 65 years.1 In 2023 a Flexible Endoscopic Evaluation of Swallowing (FEES) service was introduced into the hospital. The purpose of this study was to profile the patients who were referred for FEES and determine the prevalence and severity of dysphagia. Methods Information on patient diagnosis, dysphagia related clinical outcome measures and waiting times when compared to Videofluoroscopy referral were collected from 30 patients who attended for FEES assessment in a rehabilitation hospital from August 2023 - May 2024. Results 97% of the patients who engaged in FEES were above the age of 65. Patients presented with a range of diagnoses including frailty (20%), progressive neurological conditions (18%), other (16.6%), stroke (13.3%), Chronic Obstructive Pulmonary Disease (13.3%), Acquired Brain Injury (3%), Gastroenterology (3%), and surgical (3%). Dysphagia was identified in 97% of patients, with 60% presenting within the moderate to severe range on the Australian Therapy Outcome Measures. 33% of patients presented with silent aspiration, with a third of these patients presenting as clinically asymptomatic. Following FEES evaluation, 40% of patients were recommended a change in diet texture or fluid consistency, with 54% and 70% of these patients being recommended a downgrade in diet or fluids respectively. The service has allowed for more timely access to instrumental swallow assessment with completion of FEES within an average of 4 days compared to referral for Videofluoroscopy; 24 days average. Conclusion This study has enabled us to profile patients accessing FEES. FEES facilitates quicker access to instrumental swallow assessment and identification of aspiration. It has also enabled targeted person centered dysphagia rehab. Reference 1. Doan, T.N et al (2022) Prevalence and methods for assessment of oropharyngeal dysphagia in older adults: a systematic review and meta-analysis. Journal of Clinical Medicine, 11(9), p.2605.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"26 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Qualitative Exploration of Undergraduate Students’ Experiences of Using Virtual Reality for Dementia Inclusive Education 大学生使用虚拟现实技术开展痴呆症包容性教育的定性探索
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.298
Elisha Stewart, Catriona Murphy
{"title":"A Qualitative Exploration of Undergraduate Students’ Experiences of Using Virtual Reality for Dementia Inclusive Education","authors":"Elisha Stewart, Catriona Murphy","doi":"10.1093/ageing/afae178.298","DOIUrl":"https://doi.org/10.1093/ageing/afae178.298","url":null,"abstract":"Background Dementia prevalence is expected to exponentially increase over the coming decades. Across society, an increased awareness of dementia inclusive environments is important, to promote inclusivity and foster empathy. The aim of this study was to explore the experiences of undergraduate students using virtual reality (VR) for dementia inclusive education. Methods Purposive sampling was employed in one University in Ireland to recruit first year undergraduate students who had completed a VR workshop on dementia inclusive environments. Five semi-structured in-person interviews were conducted during February 2024. Interviews were audio-recorded, transcribed, and thematically analysed. Results Three themes were identified. The first theme ‘Food for thought’ represented participants’ greater understanding, as a result of using VR, of the potential for design to impact the dementia experience. Participants felt as though they were able to virtually place themselves in someone else’s shoes, which was described as “eye-opening”. The second theme ‘Impact variation’ revealed that although participants’ showed enhanced levels of awareness, empathy and understanding of this global health issue, the depth of learning depended on the participants’ prior exposure to dementia. The final theme related to ‘The VR experience’ as a whole. Students described the VR experience as positive, engaging, easy to use, and revealed that they were excited to take part in the workshops. Conclusion The student experience of using VR for dementia inclusive education was positive and enlightening. Using VR to introduce universal design concepts could be integrated into a range of undergraduate programmes to foster understanding and has the potential to empower future designers and policymakers to create environments that are accessible and inclusive for everyone. While this is a small-scale study, the difference in impact of this VR initiative on students with prior personal exposure to people with dementia and those without was an interesting finding and requires further research.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"39 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“For the Care of the Underserved” A Descriptive Analysis of MTOA Admitted Under the Non-Trauma Specialties in a MTC "关爱弱势群体" 对一家医疗中心非创伤专科收治的 MTOA 的描述性分析
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.318
Clara McGurk, Alanna O'Shea, Rachel Fitzgerald, Evelyn Hannon, Emer Ahern
{"title":"“For the Care of the Underserved” A Descriptive Analysis of MTOA Admitted Under the Non-Trauma Specialties in a MTC","authors":"Clara McGurk, Alanna O'Shea, Rachel Fitzgerald, Evelyn Hannon, Emer Ahern","doi":"10.1093/ageing/afae178.318","DOIUrl":"https://doi.org/10.1093/ageing/afae178.318","url":null,"abstract":"Background The recent NOCA report highlights a significant portion of major trauma cases resulting from falls among older adults, who often face limited access to trauma centres and age-related biases in treatment. Existing protocols and services for older trauma patients are lacking. This study aimed to audit the incidence and outcomes of MTOA admitted under the non-trauma specialties at a Major Trauma Centre. Methods Data from handover documents between January 2019 and December 2023 were screened for cases of “older trauma” (patients &amp;gt;65 with new trauma injuries) and analysed using Microsoft Excel. Results Between 2019 and 2023, 992 older patients were admitted under non-trauma specialties, with a mean age of 83 years and a majority being female 73% (N=170). The mean length of stay was 14 days, with pelvis injuries being most common 31% (N=307). Falls from standing height accounted for 83% (N=823) of injuries. Only 28% (N=217) of patients at immediate risk of further fragility fractures received bone protection. Most patients were discharged home 49% (N=456), while 6% (N=55) were institutionalized. The total mortality rate in hospital was 7% (N=66). The total mortality at one year was 17% (N=121). The injury with the highest mortality in hospital 24% (N=21) and at one year 40% (N=35) was traumatic brain injuries. Conclusion This audit reveals disparities in trauma care for older patients, despite advances in the field. While initiatives like the hip fracture database have improved care for specific injuries, pathways for older trauma patients not requiring surgery are lacking. Given the excess morbidity and mortality among this population, establishing a Geriatric Trauma Service is imperative. This is in line with literature supporting the idea that older trauma patients demand specialist attention; they are not just older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"44 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Malnutrition Risk Screening and Dietitian Intervention within an Integrated Care Team for Older Persons 老年人综合护理团队中的营养不良风险筛查和营养师干预措施
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.035
Sinead Knox
{"title":"Malnutrition Risk Screening and Dietitian Intervention within an Integrated Care Team for Older Persons","authors":"Sinead Knox","doi":"10.1093/ageing/afae178.035","DOIUrl":"https://doi.org/10.1093/ageing/afae178.035","url":null,"abstract":"Background Malnutrition in older adults increases the risk of frailty. Nutritional interventions can improve frailty. A Senior Dietitian joined our Integrated Care for Older Persons Community Specialist Team (ICPOP-CST) in 2022. Our Complete Geriatric Assessment (CGA) form was redesigned in early 2023 which included the Malnutrition Screening Tool (MST). We commenced measuring handgrip strength (HGS) in late 2023. We measured the prevalence of malnutrition risk among our patients, audited MST use and explored dietetic service provision. Methods Data from the first 101 patients with a completed (new) CGA form were obtained from the service’s electronic patient database. Patients with a MST score of 0 or 1 were considered to be at low risk of malnutrition and those with a MST score of 2 or more were considered to be at risk of malnutrition. Results The mean age was 84.8±5.3 years and 65% were female. Malnutrition risk was identified in 39 (38.6%) patients. The MST was completed for 96 (95%) patients and completed correctly in 67 (69.8%). The total score was not summed in 26 out of 29 incorrectly completed screening tools (89.7%). Half (51, 50.5%) of the group of older adults received dietetic assessment and intervention. High protein, high calorie advice was provided for 38 (74.5%) of those seen by the ICPOP dietitian and for 29 (93.5 %) of those at risk of malnutrition. Onward referral to primary care dietitians was made for 14 (27.5%) of those seen by the ICPOP dietitian. HGS measurement was performed in 20 patients - 15 (75.0%) were identified to have probable sarcopenia – 11 (73.3%) of these were at risk of malnutrition. All received dietetic intervention in relation to protein and sarcopenia. Conclusion Malnutrition risk and probable sarcopenia are common among older adults referred to our ICPOP-CST team. The MST screening tool is practical and identifies those requiring dietetic intervention.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"74 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Multidisciplinary Prospective Audit of Practices of Providing Hydration to Patient in An Acute Care Setting. Stop, Think and Drink 对急症护理环境中为患者提供水分的做法进行多学科前瞻性审计。停一停,想一想,喝一喝
IF 6.7 2区 医学
Age and ageing Pub Date : 2024-09-30 DOI: 10.1093/ageing/afae178.243
Deirdre Kidney, Nicola Jackson, Alice Clancy, Sarah Harrington, Lydia Hendy, Tayla Joubert, Ciara Murphy, Sarah Dooley, Becky Murphy, Kate Grygielewicz
{"title":"A Multidisciplinary Prospective Audit of Practices of Providing Hydration to Patient in An Acute Care Setting. Stop, Think and Drink","authors":"Deirdre Kidney, Nicola Jackson, Alice Clancy, Sarah Harrington, Lydia Hendy, Tayla Joubert, Ciara Murphy, Sarah Dooley, Becky Murphy, Kate Grygielewicz","doi":"10.1093/ageing/afae178.243","DOIUrl":"https://doi.org/10.1093/ageing/afae178.243","url":null,"abstract":"Background In the Dementia Friendly Hospital Guidelines 2018, it recommends we support patient safety, health and well-being. This can be facilitated by supporting diet, nutrition and hydration in a calm, accessible and usable space with appropriate lighting, and clearly visible and easily understood furniture and tableware. We have audited our practices across the hospital to ensure we have practices that promote hydration in all our wards. As we are an MDT team we bring a unique broad perspective on the issue of availability, accessibility and assistance. Methods We prospectively audited the provision and accessibility of drinks of any kind across our hospital. This was carried out on two separate occasions, once in the morning and once in the afternoon. We developed a unique audit tool. We used the HIQA nutrition and hydration standards to develop this tool. This was carried out on two separate occasions, once in the morning and once in the afternoon. Results Total number audited - 131 Availability Accessibility Assistance - 38% required prompting/reminding to drink. Conclusion Almost all of our patients in St. Michael’s Hospital had a drink and water jug available, however not all patients were able to access or independently hydrate themselves. Through making improvements, we aim to improve the hydration for our patients. According to the Food, Nutrition and Hydration policy for adults in acute hospital, by improving patient hydration, we are supporting the reduction of malnutrition amongst our patient cohort, in turn reducing their susceptibility to disease and improving their rate of recovery.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"56 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信