An evaluation of opioid use during acute hospital admissions

2022 ◽  
Vol 4 (1) ◽  
pp. 24-31
Author(s):  
Alison Blackburn
Keyword(s):  
Acute Pain ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Opioid Use ◽  
Opioid Medication ◽  
Age Range ◽  
The Impact ◽  
Acute Hospital Setting

Long-term opioid use can begin with the treatment of acute pain. However, there is little evidence concerning the impact that better opioid awareness in the acute phase may have on reducing the use of opioids in the long term. This project explored which opioids are routinely prescribed within an acute hospital setting and how these opioids were used over the course of the hospital stay. Codeine and morphine remain the most commonly prescribed opioids. Opioids were prescribed and given to people across the age range, from 16 to 98 years. The project found that 19% of patients were admitted with a pre-existing opioid. Up to 66% of patients were discharged with opioid medication, with almost 20% leaving with more than one opioid. Regular opioid use routinely exposes patients to long-term opioid use and those patients initiated onto opioid medication during admission should have the benefit of planned de-escalation before discharge.

An evaluation of opioid use during acute hospital admissions

2020 ◽  
Vol 29 (12) ◽  
pp. 700-705
Author(s):  
Alison Blackburn
Keyword(s):  
Acute Pain ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Opioid Use ◽  
Opioid Medication ◽  
Age Range ◽  
The Impact ◽  
Acute Hospital Setting

Long-term opioid use can begin with the treatment of acute pain. However, there is little evidence concerning the impact that better opioid awareness in the acute phase may have on reducing the use of opioids in the long term. This project explored which opioids are routinely prescribed within an acute hospital setting and how these opioids were used over the course of the hospital stay. Codeine and morphine remain the most commonly prescribed opioids. Opioids were prescribed and given to people across the age range, from 16 to 98 years. The project found that 19% of patients were admitted with a pre-existing opioid. Up to 66% of patients were discharged with opioid medication, with almost 20% leaving with more than one opioid. Regular opioid use routinely exposes patients to long-term opioid use and those patients initiated onto opioid medication during admission should have the benefit of planned de-escalation before discharge.

scholarly journals An evaluation of a virtual COVID-19 ward to accelerate the supported discharge of patients from an acute hospital setting:

2021 ◽  
pp. 1-9
Author(s):  
Jim Swift ◽  
Zoe Harris ◽  
Alex Woodward ◽  
Noel O'Kelly ◽  
Chris Barker ◽  
...  
Keyword(s):  
Patient Safety ◽  
Resource Use ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Community Based ◽  
Discharge From Hospital ◽  
The Impact ◽  
Acute Hospital Setting ◽  
Multi Disciplinary Team

Background/Aims In response to high numbers of hospital admissions as a result of COVID-19, a virtual ward was implemented to achieve accelerated discharge from hospital without compromising patient safety. This study assessed the impact of this virtual ward for patients admitted to the acute hospital setting with COVID-19. Methods A community-based intervention using digital technology and a multi-disciplinary team of specialist clinicians to monitor patients at home was established. An analysis was carried out within the service investigating the safety, health outcomes and resource use of the first 65 patients discharged from hospital into the virtual respiratory ward. Results Red days, where an urgent response was required, decreased from 33.8% of patients in their first 3 days at the virtual ward to 10.8% in their final 3 days (P=0.002). Four patients were readmitted to hospital, all for clotting disorders. There was one death, which was deemed unrelated to COVID-19. Length of stay was also reduced by 40.3% (P<0.001) and estimated overall savings were £68 052 (£1047 per patient). Conclusions The virtual ward appeared to assist with earlier discharges, had a low rate of clinically necessary re-admissions, and seemed to reduce costs without compromising patient safety. The authors believe that this intervention could be applied across other NHS trusts facing similar capacity issues as a result of COVID-19.

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 Older people’s perceptions of the impact of Dance for Health sessions in an acute hospital setting: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044027
Author(s):  
Hilary Bungay ◽  
Suzanne Hughes
Keyword(s):  
Physical Activity ◽  
Social Interaction ◽  
Older People ◽  
Hospital Setting ◽  
Well Being ◽  
Acute Hospital ◽  
Emotional Impact ◽  
Psychological Benefits ◽  
The Impact ◽  
Acute Hospital Setting

ObjectivesTo explore the perceptions of hospitalised older people and their relatives of the impact of taking part in group dance sessions in an acute hospital setting.DesignA qualitative descriptive approach was used.SettingAn acute hospital trust in the East of England.ParticipantsPurposive sample of dance group participants.InterventionWeekly music and movement sessions for frail older people on Department of Elderly Medicine Wards and the Stroke Rehabilitation Unit. Sessions take place in the ward and are facilitated by a dance artist supported by ward staff.ResultsTwenty-one semistructured interviews were conducted with older people and/or their relatives. Thematic analysis of the data identified three overarching themes: (1) dance as a physical activity, (2) dance as an opportunity for social interaction and (3) the dance group as a source of emotional support. Sessions were valued as an enjoyable way to undertake physical activity and provided an opportunity for social interaction between patients. This is important as loneliness and boredom are a common occurrence during hospitalisation and are detrimental to overall health and well-being. Patients reported an emotional impact though taking part; happiness from engaging with the group and the release of pent up emotions through the triggering of memories by the music and conversations within the group.ConclusionDance for Health provides a range of physical, social and emotional benefits for hospitalised older people. Further research is required to investigate the effectiveness of group dance sessions in increasing physical activity on an acute ward and the potential psychological benefits for hospitalised older people.

scholarly journals THE IMPACT OF FOOT AND NAIL CONDITION ON FALLING, IN THE CONTEXT OF THE ELDERLY IN ACUTE HOSPITAL SETTINGS

2015 ◽  
pp. 1-4
Author(s):  
R. Rokkaku ◽  
S. Kaneko
Keyword(s):  
Risk Factor ◽  
Hospital Setting ◽  
The Elderly ◽  
Nursing Intervention ◽  
Acute Hospital ◽  
Foot Care ◽  
Risk Of Falling ◽  
The Impact ◽  
The Relationship ◽  
Acute Hospital Setting

Abstract: This study investigates the relationship between in-patient foot and nail condition and their falling. The purpose is to determine if a nursing intervention can reduce the risk of falling in the acute hospital setting. We found that the group of those had fallen significantly suffered from abnormalities of their feet and/or nail. It became especially clear that falling was related to tinea, excessive keratin, and excessively long nails. Also, there were few nurses who were aware that foot and nail condition are a risk factor of falling. Relatedly, their concern for the condition of patients’ feet and nails was low. We recommend that nurses and patients improve the condition of feet and nails to reduce falling by the elderly in an acute hospital setting. In addition, we conclude that foot care enhances the lower extremities’ physiological functions.

scholarly journals Evaluating the impact of reflective practice groups for nurses in an acute hospital setting

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Benjamin R Davey ◽  
Samuel J Byrne ◽  
Prudence M Millear ◽  
Chris Dawber ◽  
Luigi Medoro
Keyword(s):  
Reflective Practice ◽  
Hospital Setting ◽  
Acute Hospital ◽  
The Impact ◽  
Acute Hospital Setting

Appropriateness and avoidability of terminal hospital admissions: Results of a survey among family physicians

2016 ◽  
Vol 31 (5) ◽  
pp. 456-464 ◽  
Author(s):  
Thijs Reyniers ◽  
Luc Deliens ◽  
H Roeline W Pasman ◽  
Robert Vander Stichele ◽  
Bart Sijnave ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Family Physicians ◽  
Acute Hospital ◽  
University Hospital ◽  
Academic Level ◽  
Hospital Deaths ◽  
Time Of Admission ◽  
Acute Hospital Setting

Background: Although the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life. Aim: To examine what proportion of terminal hospital admissions among their patients family physicians consider to have been avoidable and/or inappropriate; which patient, family physician and admission factors are associated with the perceived inappropriateness or avoidability of terminal hospital admissions; and which interventions could have prevented them, from the perspective of family physicians. Design: Survey among family physicians, linked to medical record data. Setting: Patients who had died non-suddenly in the acute hospital setting of a university hospital in Belgium between January and August 2014. Results: We received 245 completed questionnaires (response rate 70%) and 77% of those hospital deaths ( n = 189) were considered to be non-sudden. Almost 14% of all terminal hospital admissions were considered to be potentially inappropriate, almost 14% potentially avoidable and 8% both, according to family physicians. The terminal hospital admission was more likely to be considered potentially inappropriate or potentially avoidable for patients who had died of cancer, when the patient’s life expectancy at the time of admission was limited, by family physicians who had had palliative care training at basic, postgraduate or post-academic level, and when the admission was initiated by the patient, partner or other family. Conclusion: Timely communication with the patient about their limited life expectancy and the provision of better support to family caregivers may be important strategies in reducing the number of hospital deaths.

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