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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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Does acute care for the elderly (ACE) unit decrease the incidence of falls?

Ahmed Abdalla1, Mehul Adhaduk1, Raad A Haddad1

  • 1Internal Medicine Residency Program, Hurley Medical Center, Michigan State University, 1 Hurley Plaza, Flint, MI 48503, USA.

Geriatric Nursing (New York, N.Y.)
|November 16, 2017
PubMed
Summary
This summary is machine-generated.

Acute Care for the Elderly (ACE) units significantly reduce patient falls by an estimated 73% compared to general medical and surgical (GMS) units. Investing in ACE units can lower fall risks and associated healthcare costs.

Keywords:
ACEAcute care for the elderlyFallsMorse Fall ScoreOlder patients

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Area of Science:

  • Geriatrics
  • Patient Safety
  • Healthcare Management

Background:

  • Patient falls are a significant concern in hospitals, leading to increased morbidity, mortality, and healthcare expenses.
  • General medical and surgical (GMS) units may not be optimally designed or staffed to meet the complex needs of elderly patients.
  • Acute Care for the Elderly (ACE) units are specialized geriatric inpatient services designed to improve care for older adults.

Purpose of the Study:

  • To compare the incidence of patient falls in Acute Care for the Elderly (ACE) units versus general medical and surgical (GMS) units.
  • To quantify the reduction in falls associated with ACE unit care.
  • To provide evidence for the effectiveness of ACE units in enhancing patient safety for elderly individuals.

Main Methods:

  • A non-concurrent prospective study design was employed over a two-year period.
  • Data were collected on 7069 admissions, totaling 28,401 patient-days, across ACE and GMS units.
  • Statistical analysis adjusted for covariates including age, sex, psychotropic/hypnotic medication use, and Morse Fall Score.

Main Results:

  • An overall incidence rate of 5.2 falls per 1000 patient-days was reported.
  • The adjusted incidence rate ratio (IRR) for falls in ACE units compared to non-ACE units was 0.27 (95% CI, 0.13-0.54; p < 0.001).
  • This represents an estimated 73% reduction in patient falls within ACE units.

Conclusions:

  • Acute Care for the Elderly (ACE) units demonstrate a significant reduction in patient falls compared to general medical and surgical units.
  • The findings suggest that specialized geriatric care models like ACE units improve patient safety.
  • Hospitals should consider implementing ACE units to mitigate fall risks and reduce associated medical and financial burdens.