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Related Experiment Videos

Modified hospital elder life program: effects on abdominal surgery patients.

Cheryl Chia-Hui Chen1, Ming-Tsan Lin, Yu-Wen Tien

  • 1Department of Nursing, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan. cherylchen@ntu.edu.tw

Journal of the American College of Surgeons
|June 7, 2011
PubMed
Summary

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A modified Hospital Elder Life Program (HELP) significantly reduced postsurgical functional decline and delirium in older patients. This cost-effective intervention, focusing on mobilization, nutrition, and cognitive activities, improved patient outcomes.

Area of Science:

  • Geriatric Medicine
  • Surgical Patient Care
  • Hospital Quality Improvement

Background:

  • Postsurgical functional decline is a significant concern for older adults, increasing frailty and mortality risk.
  • Comprehensive programs like the Hospital Elder Life Program (HELP) are effective but can be resource-intensive.
  • Modifying HELP for surgical patients may offer a cost-effective approach to mitigate decline.

Purpose of the Study:

  • To evaluate the effectiveness of a modified Hospital Elder Life Program (HELP) in reducing postsurgical functional decline in older adults.
  • To assess the impact of the modified HELP on nutritional status, cognitive function, and delirium rates.
  • To determine the cost-effectiveness and feasibility of implementing a targeted HELP intervention for surgical patients.

Main Methods:

Related Experiment Videos

  • A quasi-experimental design comparing a modified HELP intervention group (n=102) with a usual care control group (n=77) of older surgical patients.
  • The modified HELP included early mobilization, nutritional assistance, and therapeutic cognitive activities, delivered by a trained nurse.
  • Primary endpoints included changes in activities of daily living, nutritional status, and cognitive function from admission to discharge.

Main Results:

  • Patients receiving the modified HELP intervention showed significantly less decline in activities of daily living and nutritional status compared to controls (p < 0.001).
  • The incidence of delirium was significantly lower in the HELP group (0%) versus the control group (16.7%) (p < 0.001).
  • These benefits were observed independently of baseline function, education, diagnosis, comorbidities, surgical procedure, and surgery duration.

Conclusions:

  • A modified HELP intervention, implemented by a trained nurse, effectively reduced functional decline and delirium in older surgical patients by hospital discharge.
  • The program proved to be cost-effective, though successful implementation requires strong physician and nursing leadership commitment.
  • This targeted approach offers a valuable strategy for improving outcomes in elderly surgical populations.