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首页> 外文期刊>Trials >Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit
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Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

机译：对医疗和心理健康部门的评估与标准护理的比较，针对因急诊并发并发“混淆”而并发急诊的老年人：一项对照临床试验。缩略语：TEAM：老年急性护理医学和心理健康部门的试用

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Background Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences. We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period. Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach, a programme of meaningful activity was devised, the environment adapted to the needs of people with cognitive impairment, and attention given to communication with family carers. We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective. Methods/design We will perform a controlled clinical trial comparing in-patient management on a specialist Medical and Mental Health Unit with standard care. Study participants are patients over the age of 65, admitted as an emergency to a single general hospital, and identified on the Acute Medical Admissions Unit as being 'confused'. Sample size is 300 per group. The evaluation design has been adapted to accommodate pressures on bed management and patient flows. If beds are available on the specialist Unit, the clinical service allocates patients at random between the Unit and standard care on general or geriatric medical wards. Once admitted, randomised patients and their carers are invited to take part in a follow up study, and baseline data are collected. Quality of care and patient experience are assessed in a non-participant observer study. Outcomes are ascertained at a follow up home visit 90 days after randomisation, by a researcher blind to allocation. The primary outcome is days spent at home (for those admitted from home), or days spent in the same care home (if admitted from a care home). Secondary outcomes include mortality, institutionalisation, resource use, and scaled outcome measures, including quality of life, cognitive function, disability, behavioural and psychological symptoms, carer strain and carer satisfaction with hospital care. Analyses will comprise comparisons of process, outcomes and costs between the specialist unit and standard care treatment groups. Trial Registration number ClinicalTrials.gov: NCT01136148
机译：背景：综合医院收治的患有ir妄和痴呆症的患者预后较差，其护理人员的经验较差。在十八个月的时间内，我们将急诊科病房发展成为专业的心理健康科。雇用了其他专业的精神卫生人员，对其他人员进行了以“以人为中心”的痴呆护理方法的培训，制定了有意义的活动计划，适应了认知障碍患者需求的环境，并重视与家人的沟通照顾者。我们假设，在该病房接受治疗的患者将比接受标准护理的患者有更好的结局，并且这种护理将具有成本效益。方法/设计我们将进行对照临床试验，将专业医疗和心理健康部门的住院治疗与标准护理进行比较。研究对象是65岁以上的患者，他们被急诊入了一家综合医院，并在急性医疗住院处被确认为“困惑”。每组样本量为300。评估设计经过调整，可以适应病床管理和患者流量方面的压力。如果专科病房有病床，则临床服务会在普通病房或老年病房的标准病房和标准病房之间随机分配患者。入院后，将邀请随机分组的患者及其护理人员参加随访研究，并收集基线数据。一项非参与的观察者研究评估了护理质量和患者经验。随机分配90天后由不知情分配的研究人员在随访家访中确定结局。主要结局是在家里度过的天数（对于那些在家中收养的人），或者在同一家疗养院中的天数（如果从护理院收养的话）。次要结局包括死亡率，机构化，资源利用和规模化的结局指标，包括生活质量，认知功能，残疾，行为和心理症状，照顾者压力和照顾者对医院护理的满意度。分析将包括专家单位和标准护理治疗组之间的过程，结果和成本的比较。试验注册号ClinicalTrials.gov：NCT01136148

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