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首页> 外文期刊>Journal of the American Geriatrics Society >The Hospital Elder Life Program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital Elder Life Program.
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The Hospital Elder Life Program: a model of care to prevent cognitive and functional decline in older hospitalized patients. Hospital Elder Life Program.

机译：医院老年人生活计划：一种防止老年住院患者认知和功能下降的护理模型。医院老年人计划。

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OBJECTIVES: To describe the Hospital Elder Life Program, a new model of care designed to prevent functional and cognitive decline of older persons during hospitalization. PROGRAM STRUCTURE AND PROCESS: All patients aged > or =70 years on specified units are screened on admission for six risk factors (cognitive impairment, sleep deprivation, immobility, dehydration, vision or hearing impairment). Targeted interventions for these risk factors are implemented by an interdisciplinary team-including a geriatric nurse specialist, Elder Life Specialists, trained volunteers, and geriatricians--who work closely with primary nurses. Other experts provide consultation at twice-weekly interdisciplinary rounds. INTERVENTION: Adherence is carefully tracked. Quality assurance procedures and performance reviews are an integral part of the program. PROGRAM OUTCOMES: To date, 1,507 patients have been enrolled during 1,716 hospital admissions. The overall intervention adherence rate was 89% for at least partial adherence with all interventions during 37,131 patient-days. Our results indicate that only 8% of admissions involved patients who declined by 2 or more points on MMSE and only 14% involved patients who declined by 2 or more points on ADL score. Comparative results for the control group from the clinical trial were 26% and 33%, and from previous studies 14 to 56% and 34 to 50% for cognitive and functional decline, respectively. Effectiveness of the program for delirium prevention and of the program's nonpharmacologic sleep protocol have been demonstrated previously. CONCLUSIONS: These results suggest that the Hospital Elder Life Program successfully prevents cognitive and functional decline in at-risk older patients. The program is unique in its hospital-wide focus; in providing skilled staff and volunteers to implement interventions; and in targeting practical interventions toward evidence-based risk factors. Future studies are needed to evaluate cost-effectiveness and longterm outcomes of the program as well as its effectiveness in non-hospital settings.
机译：目的：描述医院老年生活计划，这是一种旨在防止老年人在住院期间功能和认知能力下降的新型护理模式。计划的结构和过程：所有入院特定年龄≥70岁的患者均入院时筛查六个危险因素（认知障碍，睡眠不足，行动不便，脱水，视力或听力障碍）。这些风险因素的针对性干预措施是由跨学科团队实施的，他们与老年护士密切合作，包括老年病护理专家，老年专家，受过训练的志愿者和老年病医师。其他专家在每周两次的跨学科轮次中提供咨询。干预：遵守严格遵守。质量保证程序和性能审查是该计划的组成部分。计划成果：迄今为止，在1,716例住院期间已纳入1,507例患者。在37,131个患者日内，所有干预措施的至少部分坚持治疗的总体干预遵守率为89％。我们的结果表明，只有8％的入院患者的MMSE得分下降2分或更多，而只有14％的患者的ADL得分下降2分或更多。来自临床试验的对照组的比较结果分别为26％和33％，以及来自先前研究的认知和功能下降的分别为14％至56％和34％至50％。先前已经证明了该方案对ir妄预防的有效性以及该方案的非药物性睡眠方案的有效性。结论：这些结果表明，《医院老年生活计划》成功地防止了高危老年患者的认知和功能下降。该计划在全院范围内都是独一无二的。提供熟练的员工和志愿者实施干预措施;以及针对基于证据的危险因素进行实际干预。需要进行进一步的研究以评估该计划的成本效益和长期结果以及其在非医院环境中的有效性。

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