scholarly journals Elderspeak in Acute Hospitals? The Role of Context, Cognitive and Functional Impairment

2020 ◽  
pp. 016402752094909
Author(s):  
Eva-Luisa Schnabel ◽  
Hans-Werner Wahl ◽  
Christina Streib ◽  
Thomas Schmidt
Keyword(s):  
Functional Impairment ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Computer Assisted ◽  
Stereotype Activation ◽  
Individual Level ◽  
Acute Hospitals ◽  
Level Information ◽  
Recorded Data

Older adults are often exposed to elderspeak, a specialized speech register linked with negative outcomes. However, previous research has mainly been conducted in nursing homes without considering multiple contextual conditions. Based on a novel contextually-driven framework, we examined elderspeak in an acute general versus geriatric German hospital setting. Individual-level information such as cognitive impairment (CI) and audio-recorded data from care interactions between 105 older patients ( M = 83.2 years; 49% with severe CI) and 34 registered nurses ( M = 38.9 years) were assessed. Psycholinguistic analyses were based on manual coding (κ = .85 to κ = .97) and computer-assisted procedures. First, diminutives (61%), collective pronouns (70%), and tag questions (97%) were detected. Second, patients’ functional impairment emerged as an important factor for elderspeak. Our study suggests that functional impairment may be a more salient trigger of stereotype activation than CI and that elderspeak deserves more attention in acute hospital settings.

The changing role of GP clinicians working in community hospitals.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696713
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Helen Tucker ◽  
Angela Ellis-Paine ◽  
Jon Glasby
Keyword(s):  
Medical Care ◽  
Local Community ◽  
Community Hospital ◽  
Clinical Care ◽  
Hospital Setting ◽  
Community Hospitals ◽  
Recruitment Challenges ◽  
Acute Hospitals ◽  
Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

scholarly journals Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Michael Connolly ◽  
Mary Ryder ◽  
Kate Frazer ◽  
Eileen Furlong ◽  
Teresa Plazo Escribano ◽  
...  
Keyword(s):  
Palliative Care ◽  
Phase 1 ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Nurse Specialist ◽  
Phase 2 ◽  
Specialist Palliative Care ◽  
Clinical Nurse ◽  
Acute Hospital Setting

Abstract Background Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting. Methods This study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire (n = 121) and phase 2 involved part-taking in a focus group (n = 6) or individual interview (n = 4). Results Phase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support. Conclusions This study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.

CP-011 Length of antimicrobial use and the role of the pharmacist in an acute hospital setting

2015 ◽  
Vol 22 (Suppl 1) ◽  
pp. A5.1-A5
Author(s):  
P Nieto Guindo ◽  
H Mateo Carrasco ◽  
D Fernández Ginés ◽  
F Verdejo Reche ◽  
JM Ruiz Gonzalez
Keyword(s):  
Hospital Setting ◽  
Acute Hospital ◽  
Antimicrobial Use ◽  
Acute Hospital Setting

scholarly journals Delirium in the acute hospital setting: the role of psychiatry

2020 ◽  
Vol 27 (1) ◽  
pp. 49-59
Author(s):  
James M. FitzGerald ◽  
Annabel Price
Keyword(s):  
Hospital Admissions ◽  
Institutional Care ◽  
Hospital Setting ◽  
Clinical Importance ◽  
Acute Hospital ◽  
Evidence Based ◽  
Research And Education ◽  
Evidence Based Care ◽  
Acute Hospital Setting

SUMMARYIn this overview we discuss the role of psychiatry in managing delirium in acute hospital admissions. We briefly discuss the role psychiatry can offer in four main domains: (a) assessment; (b) management; (c) recovery; and (d) paradigm, education and research. In the assessment section we discuss accurately detecting delirium in the context of comorbid mixed neuropsychiatric syndromes, including depression and dementia, and the clinical importance of delirium subtyping. The management section briefly outlines pharmacological and non-pharmacological approaches to delirium and their evidence-based rationale. The recovery section focuses on the effect delirium can have on cognitive decline, mental health and long-term health, including functional outcome and need for institutional care after hospital discharge. Finally, we outline the role of psychiatry in delirium research and education. We hope that this article will encourage clinicians to reflect on their current practice and consider holistic and evidence-based care for this vulnerable population in the acute hospital setting.

scholarly journals Evaluating the Specialist Palliative Care Clinical Nurse Specialist Role in an Acute Hospital Setting: A Mixed Methods Sequential Explanatory Study.

2021 ◽  
Author(s):  
Michael Connolly ◽  
Mary Ryder ◽  
Kate Frazer ◽  
Eileen Furlong ◽  
Teresa Plano Escribano ◽  
...  
Keyword(s):  
Palliative Care ◽  
Phase 1 ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Nurse Specialist ◽  
Phase 2 ◽  
Specialist Palliative Care ◽  
Clinical Nurse ◽  
Acute Hospital Setting

Abstract Background Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting. Methods This study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire and phase 2 involved part-taking in a focus group interview. Results Phase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support Conclusions This study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.

Predictive Role of Functional Metrics in the Acute Hospital Setting

2018 ◽  
Vol 99 (10) ◽  
pp. e112
Author(s):  
Conan So ◽  
Daniel Lage ◽  
Chloe Slocum ◽  
Jeffrey C. Schneider
Keyword(s):  
Hospital Setting ◽  
Acute Hospital ◽  
Predictive Role ◽  
Acute Hospital Setting ◽  
Functional Metrics

scholarly journals Extent of palliative care need in the acute hospital setting: a prospective survey of two acute hospitals in the UK

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A13.2-A13 ◽  
Author(s):  
Clare Gardiner ◽  
Christine Ingleton ◽  
Merryn Gott ◽  
Bill Noble ◽  
Mike Bennett ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Prospective Survey ◽  
Acute Hospitals ◽  
The Uk ◽  
Acute Hospital Setting

scholarly journals Extent of palliative care need in the acute hospital setting: A survey of two acute hospitals in the UK

2012 ◽  
Vol 27 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Clare Gardiner ◽  
Merryn Gott ◽  
Christine Ingleton ◽  
Jane Seymour ◽  
Mark Cobb ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Staff ◽  
Medical Staff ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Self Report ◽  
Care Needs ◽  
Acute Hospitals ◽  
Palliative Care Needs ◽  
Acute Hospital Setting

Background: In common with international health policy, The End of Life Care Strategy for England has highlighted the delivery of high quality palliative care in the acute hospital setting as an area of priority. Aim: The aim of this study was to explore the extent of palliative care need in the acute hospital setting, and to explore agreement between different sources in the identification of patients with palliative care need. Design: A cross-sectional survey of palliative care need was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Medical and nursing staff were asked to identify patients with palliative care needs. Patients (or consultees) completed assessments of palliative care need. Participants: Of a total in-patient population of 1359, complete datasets were collected for 514 patients/consultees. Results: 36.0% of patients were identified as having palliative care needs according to GSF criteria. Medical staff identified 15.5% of patients as having palliative care needs, and nursing staff 17.4% of patients. Patient self-report data indicated that 83.2% of patients meeting GSF criteria had palliative care needs. Conclusion: The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need. Consensus between medical staff, nursing staff and the GSF was poor regarding the identification of patients with palliative care needs. This has significant implications for patient care, and draws into question the utility of the GSF in the hospital setting.

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