Abstract
Hospitalized older adults may experience a decline in functional status from their preadmission baseline, over the course of a hospital stay, and often improve little by the time of discharge, regardless of the admitting diagnosis. Elements of hospitalization including the physical environment and some patient care practices can contribute to poor outcomes; one area in which older hospitalized patients are at high risk is functional decline. Models of care have been designed to prevent functional decline and achieve better outcomes for hospitalized elders. The Acute Care for the Elderly (ACE) model integrates a physical environment designed to foster functional independence along with changes in nursing and medical care delivery, specially trained staff and an interprofessional team approach.
The purpose of this study was to examine the effect of the Acute Care for the Elderly model on functional decline and associated nurse sensitive outcomes (falls, nosocomial pressure ulcers, and nosocomial urinary tract infections) compared to a regular medical unit. This study was a prospective observational trial that utilized a quasi-experimental, potentially non-equivalent, control group design to compare complications in two different hospital treatment groups (ACE unit and a regular medical unit).
There was a significant difference in percentage change in functional status between the two groups, participants on the ACE unit improved in their ability to perform basic activities of daily living as compared to participants on the comparison unit, controlling for medical comorbidities and level of orientation (F=18, p<0.0001). On average, participants on the ACE unit improved their functional status by 49%, while those on the comparison unit demonstrated, on average, functional decline of 7%. There were not enough occurrences of falls, nosocomial pressure ulcers and nosocomial urinary tract infections in this sample for statistical modeling.
The ACE unit is one model of care that has strong evidence that it is possible to prevent the hazards of hospitalization and promote positive outcomes by redesigning the hospital unit and care delivery. The findings of this study support the ACE model of care and its role in improving outcomes for hospitalized older adults.
Sigma Membership
Omega Delta
Type
Dissertation
Format Type
Text-based Document
Study Design/Type
Quasi-Experimental Study, Other
Research Approach
Mixed/Multi Method Research
Keywords:
Elderly Adults, Patient Outcomes, Patient Care
Advisors
Capezuti, Elizabeth||Fulmer, Terry||Siegler, Eugenia
Degree
PhD
Degree Grantor
New York University
Degree Year
2007
Recommended Citation
Wexler, Sharon S., "A comparison of nurse sensitive outcomes of an acute care for the elderly (ACE) unit and a regular inpatient medical unit" (2023). Dissertations. 1204.
https://www.sigmarepository.org/dissertations/1204
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
None: Degree-based Submission
Acquisition
Proxy-submission
Date of Issue
2023-03-24
Full Text of Presentation
wf_yes
Description
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3293028; ProQuest document ID: 304830349. The author still retains copyright.