在急症护理环境中实施老年人友好型护理倡议：克服挑战并衡量结果

IF 2.5 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing Pub Date : 2025-04-09 DOI:10.1016/j.gerinurse.2025.03.034

Lise Cooper DMH, MSN, RN, MEDSURG-BC, Keerti Sharma MD, Brittney Daley DNP, RN, CCRN, Byol Kim BSN, RN-BC, Krystal Fitzpatrick MSN, RN, PCCN, CNML, Marilynn Robayo MSN-Ed., RN, MEDSURG-BC, Brandee A. Fetherman MSN, RN, CENP, CCRN, Mildred Ortu Kowalski PhD, RN, NE-BC

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引用次数: 0

摘要

美国人口老龄化需要创新的护理方法。我们的医疗中心采用“计划-执行-研究-行动”的质量改进方法，实施了老年人友好型卫生系统“4Ms”框架——“重要的是什么”、“药物”、“心理状态”和“行动”。该项目于2019年12月在两个住院病房启动，由护士主导，旨在改善对70岁以上住院成年人的护理。主要干预措施包括加强患者目标的记录，减少高风险药物，实施谵妄预防策略，并支持活动。跟踪的指标包括4Ms依从性、Beers®标准用药订单、谵妄发生率和行走距离。结果5年内，4Ms依从性从81%上升到100%，比尔斯标准用药订单减少，行走距离增加，跌倒和谵妄率保持稳定。患者教育举措提高了满意度。结论：成功的4Ms计划已扩展到所有住院单位，并正在全系统范围内实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Implementation of an age-friendly care initiative in an acute care setting: Overcoming challenges and measuring outcomes

Background

The aging U.S. population requires innovative care approaches. Our medical center implemented the Age-Friendly Health Systems "4Ms" framework—what Matters, Medication, Mentation, and Mobility—using a Plan-Do-Study-Act quality improvement approach.

Methods

Launched in December 2019 on two inpatient units, this nurse-led project aimed to improve care for hospitalized adults aged 70+. Key interventions included enhancing documentation of patient goals, reducing high-risk medications, implementing delirium prevention strategies, and supporting mobility. Metrics tracked included 4Ms adherence, Beers® Criteria medication orders, delirium incidence, and ambulation distances.

Results

Over five years, 4Ms adherence rose from 81% to 100%, Beers Criteria medication orders decreased, and ambulation distances improved while falls and delirium rates remained stable. Patient education initiatives enhanced satisfaction.

Conclusions

The successful 4Ms initiative has expanded across all inpatient units and is being implemented system wide.

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来源期刊

Geriatric Nursing 医学-护理

CiteScore

3.80

自引率

7.40%

发文量

257

审稿时长

>12 weeks

期刊介绍： Geriatric Nursing is a comprehensive source for clinical information and management advice relating to the care of older adults. The journal''s peer-reviewed articles report the latest developments in the management of acute and chronic disorders and provide practical advice on care of older adults across the long term continuum. Geriatric Nursing addresses current issues related to drugs, advance directives, staff development and management, legal issues, client and caregiver education, infection control, and other topics. The journal is written specifically for nurses and nurse practitioners who work with older adults in any care setting.