共 31 条
[31]
WHO, 2008, ACT PLAM GLOB STRAT
Multidisciplinary team interventions to optimise health outcomes for older people in acute care settings: A systematic review
被引：63
作者：
Hickman, Louise D.
[1
]
Phillips, Jane L.
[2
]
Newton, Phillip J.
[2
]
Halcomb, Elizabeth J.
[3
]
Al Abed, Naser
[1
]
Davidson, Patricia M.
[4
]
机构：
[1] Univ Technol Sydney, Fac Hlth, POB 123,15 Broadway, Ultimo, NSW 2007, Australia
[2] Univ Technol Sydney, Fac Hlth, Ctr Cardiovasc & Chron Care, Sydney, NSW 2007, Australia
[3] Univ Wollongong, Sch Nursing, Wollongong, NSW 2522, Australia
[4] Johns Hopkins Univ, Sch Nursing, Baltimore, MD 21205 USA
关键词：
Transition;
Functional health status;
Geriatric assessment;
Hospitalization;
Multidisciplinary;
RANDOMIZED CONTROLLED-TRIAL;
DISCHARGE-PLANNING INTERVENTION;
GERIATRIC INTERVENTION;
HOSPITAL READMISSION;
FUNCTIONAL DECLINE;
HIP FRACTURE;
HIGH-RISK;
PROGRAM;
ADULTS;
METAANALYSIS;
D O I：
10.1016/j.archger.2015.06.021
中图分类号：
R592 [老年病学];
C [社会科学总论];
学科分类号：
03 ;
0303 ;
100203 ;
摘要：
Background: A major challenge facing our health care systems internationally is managing the needs of increasing numbers of older people in hospital with chronic and complex conditions. A multidisciplinary approach is considered central to tailoring and targeting approaches to gerontological care, although this is often not realised in reality. Comprehensive geriatric assessment (CGA) is seen as gold standard, though they are not readily available in many acute settings, compounded by the requirement for time, coordination of multidisciplinary specialties, and reimbursement issues. This systematic review aimed to identify multidisciplinary team interventions to optimise health outcomes for older people in acute care settings. Method: Systematic review of randomised controlled trials reporting acute care multidisciplinary team based interventions, to improve care outcomes for hospitalised older people. Electronic databases (MEDLINE, CINAHL (EBSCO), Cochrane and PsycINFO) were searched from 1 January 2000 to 1 July 2014 in the English language. Data was extracted by two reviewers and checked by a third reviewer to resolve any conflicts. Results: Seven articles reporting RCTs met the systematic review inclusion criteria. The heterogeneity of study populations, multidisciplinary team interventions and outcome measures necessitated the use of narrative analysis. Three common elements of these studies included: (i) tailored treatment by clinicians with geriatric expertise (ii) a focus on transitional care interventions that enhance discharge planning; and (iii) communication an essential ingredient to improving care. Conclusion: The tailoring of treatment, underpinned with clear communication strategies can reduce emergency department re-admission rates, mortality and functional decline of older people. Refining health professionals roles and responsibilities within transition models is an essential component that can improve health outcomes for older people in acute care settings. Crown Copyright (C) 2015 Published by Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码：322 / 329
页数：8
相关论文