Early re-presentation to hospital after discharge from an acute medical unit: perspectives of older patients, their family caregivers and health professionals

2013 ◽  
Vol 22 (3-4) ◽  
pp. 445-455 ◽  
Author(s):  
Susan Slatyer ◽  
Christine Toye ◽  
Aurora Popescu ◽  
Jeanne Young ◽  
Anne Matthews ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Health Professionals ◽  
Older Patients ◽  
Medical Unit ◽  
Acute Medical Unit

scholarly journals Comprehensive geriatric assessment on an acute medical unit: a qualitative study of older people’s and informal carer’s perspectives of the care and treatment received

2016 ◽  
Vol 31 (1) ◽  
pp. 126-134 ◽  
Author(s):  
Janet Darby ◽  
Tracey Williamson ◽  
Pip Logan ◽  
John Gladman
Keyword(s):  
Randomized Controlled Trial ◽  
Qualitative Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Controlled Trial ◽  
Medical Unit ◽  
Randomized Controlled ◽  
Acute Medical Unit ◽  
Informal Carers

Objective: This qualitative study was imbedded in a randomized controlled trial evaluating the addition of geriatricians to usual care to enable the comprehensive geriatric assessment process with older patients on acute medical units. The qualitative study explored the perspectives of intervention participants on their care and treatment. Design: A constructivist study incorporating semi-structured interviews that were conducted in patients’ homes within six weeks of discharge from the acute medical unit. These interviews were recorded, transcribed, and analysed using thematic analysis. Setting: An acute medical unit in the United Kingdom. Participants: Older patients ( n = 18) and their informal carers ( n = 6) discharged directly home from an acute medical unit, who had been in the intervention group of the randomized controlled trial. Results: Three core themes were constructed: (1) perceived lack of treatment on the acute medical unit; (2) nebulous grasp of the role of the geriatrician; and (3) on-going health and activities of daily living needs postdischarge. These needs impacted upon the informal carers, who either took over, or helped the patients to complete their activities of daily living. Despite the help received with activities of daily living, a lot of the patients voiced a desire to complete these activities themselves. Conclusions: The participants perceived they were just monitored and observed on the acute medical unit, rather than receiving active treatment, and spoke of on-going unresolved health and activity of daily living needs following discharge, despite receiving the additional intervention of a geriatrician.

scholarly journals Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

2021 ◽  
Vol 18 (17) ◽  
pp. 9271
Author(s):  
Kirsten R.C. Hensgens ◽  
Inge H.T. van Rensen ◽  
Anita W. Lekx ◽  
Frits H.M. van Osch ◽  
Lieve H.H. Knarren ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Primary Outcome ◽  
Screening Method ◽  
Single Centre ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Single Centre Study ◽  
Screening Accuracy ◽  
Specific Symptoms

Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to evaluate the performance of our pre-triage screening method and to analyse the characteristics of initially undetected COVID-19 patients. Methods. This was a retrospective, observational, single centre study. Patients ≥ 18 years visiting the AMU-ED between 17 March and 17 April 2020 were included. Primary outcome was the (correct) number of COVID-19 patients assigned to the AMU or ED. Results. In total, 1287 patients visited the AMU-ED: 525 (40.8%) AMU, 762 (59.2%) ED. Within the ED group, 304 (64.3%) of 473 tested patients were COVID-19 positive, compared to 13 (46.4%) of 28 tested patients in the AMU group. Our pre-triage screening accuracy was 63.7%. Of the 13 COVID-19 patients who were initially assigned to the AMU, all patients were ≥65 years of age and the majority presented with gastro-intestinal or non-specific symptoms. Conclusion. Older COVID-19 patients presenting with non-specific symptoms were more likely to remain undetected. ED screening protocols should therefore also include non-specific symptoms, particularly in older patients.

scholarly journals Acute medical unit clinical skills lab

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 140-140
Author(s):  
Sarb Clare ◽  
Joe Wheeler
Keyword(s):  
Clinical Skills ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Skills Lab

scholarly journals Causes of discharge delays from the acute medical unit (AMU) in a tertiary level teaching hospital, Brunei Darussalam

2021 ◽  
pp. 201010582110061
Author(s):  
Dayang Nur Hilmiyah binti Awang Husaini ◽  
Justin Fook Siong Keasberry ◽  
Khadizah Haji Abdul Mumin ◽  
Hanif Abdul Rahman
Keyword(s):  
Observational Study ◽  
Discharge Planning ◽  
Patient Factors ◽  
Medical Unit ◽  
Prolonged Length ◽  
Acute Medical Unit ◽  
Brunei Darussalam ◽  
Medical Issues ◽  
Hospital Factors ◽  
Prolonged Hospital

Background: Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance. Objectives: The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei. Methods: A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations. Results: A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%). Conclusions: There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.

Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit

2021 ◽  
Vol 41 ◽  
pp. 208-216 ◽  
Author(s):  
Maria Dissing Olesen ◽  
Robert Mariusz Modlinski ◽  
Simon Hosbond Poulsen ◽  
Pernille Mølgaard Rosenvinge ◽  
Henrik Højgaard Rasmussen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Geriatric Patients ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Associated Risk Factors

scholarly journals Caring for Older Patients With Cancer: Estimates of the Prevalence, Burden, and Unmet Needs of Caregivers in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-690
Author(s):  
Erin Kent
Keyword(s):  
Family Caregivers ◽  
Older Patients ◽  
Unmet Needs ◽  
The United States ◽  
Population Based ◽  
Data Sources ◽  
Behavioral Risk ◽  
Ripple Effect ◽  
The Us ◽  
National Trends

Abstract In 2020, ~1.8 million Americans are expected to be newly diagnosed with cancer, with approximately 70% of cases diagnosed over the age of 65. Cancer can have a ripple effect, impacting not just patients themselves, but their family caregivers. This presentation will provide an overview of the estimates of the number of family caregivers caring for individuals with cancer in the US, focusing on older patients, from several population-based data sources: Caregiving in the US 2020, the Health Information National Trends Survey (HINTS, 2017-2019), the Behavioral Risk Factors Surveillance System (BRFSS, 2015-2019), and the National Health and Aging Trends (NHATS) Survey. The presentation will compare features of the data sources to give a comprehensive picture of the state of cancer caregiving. In addition, the presentation will highlight what is known about the experiences of cancer caregivers, including caregiving characteristics, burden, unmet needs, and ideas for improving support for family caregivers.

scholarly journals Acute medical unit staffing mismatch

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 44-44
Author(s):  
Dominic Reynish
Keyword(s):  
Medical Unit ◽  
Acute Medical Unit

Socialising Disease: Medical Categories and Inclusion of the Aged

2000 ◽  
Vol 48 (3) ◽  
pp. 383-407 ◽  
Author(s):  
Joanna Latimer
Keyword(s):  
Older People ◽  
Hospital Care ◽  
Social Inclusion ◽  
Social Problems ◽  
Older Person ◽  
Medical Unit ◽  
Life Chances ◽  
Acute Medical Unit ◽  
Medical Domain

When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.

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