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Does admission to a specialist geriatric medicine ward lead to improvements in aspects of acute medical care for older patients with dementia?
Author(s) -
Briggs Robert,
O'Shea Emma,
Siún Ana,
O'Neill Desmond,
Gallagher Paul,
Timmons Suzanne,
Kennelly Sean
Publication year - 2017
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4501
Subject(s) - medicine , dementia , geriatrics , delirium , audit , discharge planning , odds ratio , emergency medicine , family medicine , intensive care medicine , psychiatry , nursing , disease , management , economics
Objective The objective of this study is to clarify if admission to a specialist geriatric medicine ward leads to improvements in aspects of acute medical care for patients with dementia. Methods We analysed combined data involving 900 patients from the Irish and Northern Irish audits of dementia care. Data on baseline demographics, admission outcomes, clinical aspects of care, multidisciplinary assessment and discharge planning processes were collected. Results Less than one‐fifth of patients received their inpatient care on a specialist geriatric medicine ward. Patients admitted to a geriatric medicine ward were less likely to undergo a formal assessment of mobility compared with those in non‐geriatric wards (119/143 (83%) vs 635/708 (90%), odds ratio (OR) = 0.57 (0.35 to 0.94)) and were more likely to receive newly prescribed antipsychotic medication during the admission (27/54 (50%) vs 95/2809 (36%), OR = 1.95 (1.08 to 3.51)). Patients admitted to a geriatric medicine ward were more likely to have certain aspects of discharge planning initiated, including completion of a single plan for discharge (78/118 (66%) vs 275/611 (45%), OR = 2.38 (1.58 to 3.60)). Surgical wards performed more poorly on certain aspects including having a named discharge co‐ordinator (32/71, 45%) and documentation of decisions regarding resuscitation status (18/95, 19%). Conclusion Relatively low numbers of patients with dementia received care on a specialist geriatric medicine ward. There appears to be a more streamlined discharge planning process in place on these wards, but they did not perform as well as one would expect in certain areas, such as compliance with multidisciplinary assessment and antipsychotic prescribing. Copyright © 2016 John Wiley & Sons, Ltd.