1
40
2
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/j.1532-5415.2000.tb03866.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1532-5415.2000.tb03866.x</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1572-1581
Issue
12
Volume
48
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: A randomized controlled trial of Acute Care for Elders (ACE) in a community hospital
Publisher
An entity responsible for making the resource available
Journal of the American Geriatrics Society
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
2000-12
Subject
The topic of the resource
depression; illness; program; Geriatrics & Gerontology; consultation; institutionalization; functional decline; aged; medical unit; comprehensive geriatric assessment; decline; hospital outcomes; quality of care
Creator
An entity primarily responsible for making the resource
Counsell S R; Holder C M; Liebenauer L; Palmer R M; Fortinsky R H; Kresevic D M; Quinn L M; Allen K R; Covinsky K E; Landefeld C S
Description
An account of the resource
BACKGROUND: Older persons frequently experience a decline in function following an acute medical illness and hospitalization. OBJECTIVE: To test the hypothesis that a multicomponent intervention, called Acute Care for Elders (ACE), will improve functional outcomes and the process of care in hospitalized older patients. DESIGN: Randomized controlled trial. SETTING: Community teaching hospital. PATIENTS: A total of 1531 community-dwelling patients, aged 70 or older, admitted for an acute medical illness between November 1994 and May 1997. INTERVENTION: ACE includes a specially designed environment (with, for example, carpeting and uncluttered hallways); patient-centered care, including nursing care plans for prevention of disability and rehabilitation; planning for patient discharge to home; and review of medical care to prevent iatrogenic illness. MEASUREMENTS: The main outcome was change in the number of independent activities of daily living (ADL) from 2 weeks before admission (baseline) to discharge. Secondary outcomes included resource use, implementation of orders to promote function, and patient and provider satisfaction. RESULTS: Self-reported measures of function did not differ at discharge between the intervention and usual care groups by intention-to-treat analysis. The composite outcome of ADL decline from baseline or nursing home placement was less frequent in the intervention group at discharge (34% vs 40%; P =.027) and during the year following hospitalization (P = .022). There were no significant group differences in hospital length of stay and costs, home healthcare visits, or readmissions. Nursing care plans to promote independent function were more often implemented in the intervention group (79% vs 50%; P = .001), physical therapy consults were obtained more frequently (42% vs 36%; P = .027), and restraints were applied to fewer patients (2% vs 6%; r = .001). Satisfaction with care was higher for the intervention group than the usual care group among patients, caregivers, physicians, and nurses (P <.05). CONCLUSIONS: ACE in a community hospital improved the process of care and patient and provider satisfaction without increasing hospital length of stay or costs. A lower frequency of the composite outcome ADL decline or nursing home placement may indicate potentially beneficial effects on patient outcomes.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1532-5415.2000.tb03866.x" target="_blank" rel="noreferrer noopener">10.1111/j.1532-5415.2000.tb03866.x</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article or Conference Abstract Publication
2000
Aged
Allen K R
comprehensive geriatric assessment
consultation
Counsell S R
Covinsky K E
decline
Department of Family & Community Medicine
Depression
Fortinsky R H
functional decline
Geriatrics & Gerontology
Holder C M
hospital outcomes
illness
institutionalization
Journal Article or Conference Abstract Publication
Journal of the American Geriatrics Society
Kresevic D M
Landefeld C S
Liebenauer L
medical unit
NEOMED College of Medicine
Palmer R M
program
Quality of care
Quinn L M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jemermed.2012.11.047" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2012.11.047</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
291-297
Issue
2
Volume
45
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
FRAILTY ASSESSMENT IN THE EMERGENCY DEPARTMENT
Publisher
An entity responsible for making the resource available
Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2013
2013-08
Subject
The topic of the resource
disability; Emergency Medicine; fractures; functional decline; gait speed; geriatrics; identification; indexes; intervention; mortality; muscle weakness; older-adults; prediction; risk-stratification tool
Creator
An entity primarily responsible for making the resource
Stiffler K A; Finley A; Midha S; Wilber S T
Description
An account of the resource
Background: Frailty (defined as weakness, slowness, weight loss, exhaustion, and physical inactivity) is characterized by increased vulnerability to stressors. Frail older patients are at increased risk of Emergency Department (ED) visits, hospitalization, disability, and death. Objectives: Our aims were to determine the prevalence of frailty (and assess the feasibility of measuring frailty) in older ED patients. We also assessed the correlation of self-reported speed and weakness to measured values and the association between frailty and function. Methods: We performed a study of discharged ED patients aged >= 65 years. We used Fried's frailty definition and a validated activities-of-daily-living (ADL) scale. We measured self-reported and objective weakness and slowness. Data were reported as means and proportions with 95% confidence interval (CI); associations were measured using 95% CI for the differences. Ninety patients provided a 95% CI of +/- 10%. Results: The mean age of the 90 patients was 76 +/- 6.4 SD years; 51% were male. Mean assessment time was 7.4 min (95% CI 6.9-7.9). Twenty percent of patients were frail (18/90, 95% CI 12-30%). Self-report was 18% sensitive and 90% specific for objective weakness; self-report was 42% sensitive and 86% specific for objective slowness. Frail and weak patients were more likely dependent in one or more ADLs (26% difference, 95% CI 1-51% and 20% difference, 95% CI 1-41%, respectively). Conclusions: Frailty is common in discharged older ED patients. Self-reported weakness and slowness are poor predictors of their objective counterparts. Frailty was associated with ADL dependence. These two domains may be reliable markers for elderly ED patients at high risk for adverse outcomes. (C) 2013 Elsevier Inc.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jemermed.2012.11.047" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2012.11.047</a>
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2013
disability
Emergency Medicine
Finley A
Fractures
functional decline
gait speed
Geriatrics
identification
indexes
Intervention
Journal Article
Journal of Emergency Medicine
Midha S
Mortality
Muscle Weakness
older-adults
prediction
risk-stratification tool
Stiffler K A
Wilber S T