Geriatric Nursing: Growth of a Specialty

Geriatric Nursing: Growth of a Specialty

Geriatric Nursing: Growth of a Specialty

Geriatric Nursing: Growth of a Specialty

Synopsis

"The protocols in this thoroughly updated new edition address key clinical conditions and circumstances likely to be encountered by a hospital nurse caring for older adults. They represent "best practices" for acute care of the elderly as developed by nursing experts around the country as part of the Hartford Foundation's Nurses Improving Care to the Hospitalized Elderly project (NICHE). New to this edition are chapters on evaluating practice guidelines and measuring quality and outcome of care." Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Excerpt

Older patients present a challenge to hospitals in a time of nursing shortage and cost containment. The decreased length of stay, complexity of medical regimens, and multiple co-morbid conditions increase the risk of adverse health outcomes in older patients. Although the hospital is often an ideal place for patients requiring “high tech” acute care, the environment poses a threat to many older persons, particularly the frail elderly. The hospital has been viewed as a culprit for adverse outcomes for the elderly (Kohn, Corrigan, &Donaldson, 2000). Older patients frequently experience cognitive decline (usually delirium with an underlying cause), functional decline, falls, fractures, pressure ulcers, urinary incontinence, fecal impaction, dehydration, and urinary infection while hospitalized or soon after discharge. Additionally, hospitalization poses risks to older patients due to exposure to drugs, diagnostic testing, and treatments. Complications that result from these risks add to older patients already slowed convalescence period.

For many older people, hospitalization is a “sentinel event,” triggering a downward trajectory in health and function that is all too often permanent. The negative consequences of a hospitalization are particularly noticeable in the already frail older persons: those who already have compromised function, multiple chronic illnesses, cognitive impairment, or complex medications regimens. Because of cost constraints many older patients are being discharged home much earlier and much sicker, further increasing the risk of complications after discharge and the need for re-admission to the hospital. Nurses are at the forefront of care in the hospital setting and must be looked to for help in reducing adverse consequences of hospitalization. All nurses need to be knowledgeable as to the unique needs of their older patients in order to improve outcomes and quality of life. Additionally nurses, who are the primary advocates for patient care, have to meet the increasing demands of cost containment . . .

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