Geriatric functional assessment in acute care: a pilot project

Area of Science:

• Gerontology
• Geriatric Nursing
• Acute Care

Background:

• Elderly patients are at high risk for functional decline during hospitalization.
• Early assessment and intervention are crucial for managing geriatric care needs.
• Existing models for geriatric care in acute settings require further investigation.

Purpose of the Study:

• To determine if early assessment by a gerontological clinical nurse specialist (GCNS) can reduce length of stay, cost, and functional decline in elderly patients.
• To evaluate the impact of a unit-based GCNS model on patient outcomes and staff practices.
• To explore the utility of the Mini-Mental State Exam (MMSE), PULSES Profile, and Katz Index of Activities of Daily Living (Katz ADL) in acute care settings.

Main Methods:

• Pilot study involving 33 acute care patients over age 70.
• Random assignment to experimental (GCNS monitoring) or control (usual care) groups.
• Use of MMSE, PULSES Profile, and Katz ADL for patient assessment within 72 hours of admission and prior to discharge.

Main Results:

• No statistically significant differences were found between the experimental and control groups in terms of changes in length of stay, cost of stay, or functional decline.
• The GCNS observed positive trends in medical and nursing staff practices, indicating increased awareness of geriatric care needs.
• The unit-based model showed potential for improving staff practices, though not statistically significant patient outcomes in this pilot.

Conclusions:

• Early assessment by a GCNS did not yield statistically significant improvements in patient outcomes in this pilot study.
• The study highlights the need for further research with larger sample sizes to validate the benefits of a unit-based geriatric specialist model.
• Increased staff awareness of geriatric needs is a potential benefit of integrating GCNS into acute care units.