Outcomes of acutely ill older hospitalized patients following implementation of tailored models of care: a repeated measures (pre- and post-intervention) design.
BACKGROUND
There is a lack of research investigating models of nursing care for older hospitalised patients that address the nursing needs of this group.


OBJECTIVE
The objective of this study is to evaluate the efficacy of models of care for acutely older patients tailored to two contexts: an aged care specific ward and a medical ward.


METHODS
This is a repeated measures design. Efficacy of the models was evaluated in terms of: patient and nurses' satisfaction with care provided; increased activities of daily living; reduced unplanned hospital readmissions; and medication knowledge.


METHODS
An aged care specific ward and a medical ward in two Sydney teaching hospitals.


METHODS
There were two groups of patients aged 65 years or older who were admitted to hospital for an acute illness: those admitted prior to model implementation (n=232) and those admitted during model implementation (n=116). Patients with moderate or severe dementia were excluded. The two groups of nurses were the pre-model group (n=90) who were working on the medical and aged care wards for the study prior to model implementation, and the post-model group (n=22), who were the nurses working on the wards during model implementation.


METHODS
Action research was used to develop the models of care in two wards: one for an aged care specific ward and another for a general medical ward where older patients were admitted. The models developed were based on empirical data gathered in an earlier phase of this study.


RESULTS
The models were successful in both wards in terms of increasing satisfaction levels in patients and nurses (p<0.001), increasing functional independence as measured by activities of daily living (p<0.01), and increasing medication knowledge (p<0.001).


CONCLUSIONS
Findings indicate that models of care developed by nurses using an evidence-based action research strategy can enhance both satisfaction and health outcomes in older patients.
Chang
Esther
E
University of Western Sydney, School of Nursing, PO Box 1797, Penrith South DC, 1797, NSW, Australia. e.chang@uws.edu.au
Hancock
Karen
K
Hickman
Louise
L
Glasson
Janet
J
Davidson
Patricia
P
D000203:Activities of Daily Living; D000208:Acute Disease / Q000451:nursing* / Q000523:psychology; D000368:Aged / Q000523:psychology; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D016294:Models, Nursing; D009517:New South Wales; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration*; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration*; D015397:Program Evaluation; D017749:Total Quality Management / Q000458:organization & administration