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Journal article Full text available online for free

Screening for depression in older adults on an acute medical ward: the validity of NICE guidance in using two questions

Authors:
ESIWE Collins, et al
Journal article citation:
Age and Ageing, 44(5), 2015, pp.771-775.
Publisher:
Oxford University Press

Background: Depression is common in older people in general hospital settings and associated with poor outcomes. This study aimed to evaluate the validity of two screening questions recommended by the UK National Institute for Health and Clinical Excellence (NICE). Methods: One hundred and eighteen patients aged over 65 years, admitted to acute medical wards at a teaching hospital, were interviewed in a standardised manner using relevant sections of the Present State Examination—Schedules for Clinical Assessment in Neuropsychiatry to identify depression according to ICD-10 criteria. Subsequently, participants completed the two depression screening questions and the 15-item version of the Geriatric Depression Scale (GDS-15). Results: A threshold of one or more positive responses to the two NICE depression screening questions gave a sensitivity of 100%, specificity of 71%, positive predictive value (PPV) of 49% and negative predictive value (NPV) of 100%. The GDS-15 optimal cut-off was 6/7 with a sensitivity of 80%, specificity of 86%, PPV of 62% and NPV of 94%. A two-stage screening process utilising the NICE two questions followed by the GDS-15 with these cut-offs gave a sensitivity of 80%, specificity of 91%, PPV of 71% and NPV of 94%. Conclusion: The two depression questions perform well as an initial screening process for non-cognitively impaired older people in the acute medical setting. A positive response to either question would indicate that further assessment is required by a clinician competent in diagnosing depression in this population, or the possible use of a more detailed instrument such as the GDS-15 to reduce the number of false-positive cases. (Publisher abstract)

Book Full text available online for free

Learning from Trusted to Care: one year one

Authors:
WALES. Welsh Government, NHS WALES
Publisher:
Welsh Government
Publication year:
2015
Pagination:
19
Place of publication:
Cardiff

Report summarising progress and improvements made in care and practice at the Princess of Wales and Neath Port Talbot Hospitals in Wales since the independent review Trusted to Care found serious concerns about the quality of care and patient safety of frail and older people. The review made 14 recommendations for the health board and four for the Welsh Government. The report finds progress has been made in all 14 recommendation areas made to the health board. Six have been completed either fully or there are clear plans for implementation in place Eight of the recommendations still need work. The report also identifies the progress made against the Welsh Government recommendations. Improvements are identified in the areas of hydration, medication, complaints and professional accountability. (Edited publisher abstract)

Book Full text available online for free

Older people's experience of emergency hospital readmission: research report

Authors:
LAWRIE Michael, BATTYE Fraser
Publisher:
Age UK
Publication year:
2012
Pagination:
41p.
Place of publication:
London

Reducing the occurrence of emergency hospital readmission (an unplanned readmission within 28 days of leaving) for older people is a key issue for the NHS. Over the past decade, rates of emergency hospital readmission have risen, particularly for those over the age of 75. The aim of this study was to investigate older people’s experience of emergency readmission to hospital. The study comprised: qualitative interviews with 18 older people who have experienced an emergency readmission (and in several cases their families); a brief review of key policy documents and research; and 4 semi-structured interviews with senior stakeholders. Interviewees were asked to share their experience, beginning from their first admission to hospital through to the discharge and return home, and then their experience of the readmission to hospital. The findings show that emergency hospital readmission is a complex issue with multiple potential causes which range across an individual’s care pathway. However there are particular challenges to be addressed in the transition between secondary and primary care, and ensuring that a personalised care package is put in place in the community. Implications for Age UK both at the local and national levels are discussed.

Journal article

“Not just grapes and flowers”: older people's perspectives on the role and importance of hospital visiting

Authors:
GREEN Bert, et al
Journal article citation:
Quality in Ageing and Older Adults, 13(2), 2012, pp.82-88.
Publisher:
Emerald

This paper presents findings from a service user controlled research project which sought to provide commentary by older people on their experiences as visitors to hospital or as patients receiving visitors. Nine focus groups were held with a total of 43 older people at 8 different locations in North Lancashire and South Cumbria. The participants were asked about their recent experience of hospital visiting and its value to them, given their individual circumstances and those prevailing at the hospitals. Full transcripts of digital recordings from the focus groups were analysed to identify particular concerns or vivid experiences. These were classified into the following common themes: getting there and back; on the ward; and the value of visiting. The findings suggest that visitors’ needs are not always being met. Recommendations are made that could improve hospital visiting for older people, and consequently their wellbeing, including: times and rules for visitors; the response they get from staff; the potential of older visitors to help improve the welfare of the older patient; and locating older people's wards.

Book Full text available online for free

Nutritional advice in common clinical situations (revised August 2009)

Author:
BRITISH GERIATRICS SOCIETY
Publisher:
British Geriatrics Society
Publication year:
2009
Place of publication:
London

Under-nutrition in older people admitted to hospital is common, and the risk of being malnourished increases during hospitalisation. It is also poorly detected by nursing and medical staff. This good practice guide paper covers nutrition screening, the importance of creating the right environment to support eating and drinking, management of under-nutrition in hospital, ethical and legal considerations, nutrition and stroke, nutrition and dementia, and nutrition in the community and care homes. It includes reference to key resources and guidance about nutritional care in hospital, and makes recommendations covering the advice of dieticians and speech and language therapists, training to enable health professionals to assess and meet nutritional demands, management of dysphagia, policies for review of patients, and development of policies to support nutrition which include auditable standards.

Book Full text available online for free

Hungry to be heard survey: older patients’ experience of hospital meals

Author:
AGE CONCERN SCOTLAND AND HELP THE AGED SCOTLAND
Publisher:
Age Concern Scotland
Publication year:
2009
Pagination:
7p.
Place of publication:
Edinburgh

Age Concern Scotland developed the Hungry to be Heard campaign to investigate the experience of older patients and offer recommendations for future action.  As part of the campaign, research was carried out across Scotland with over 100 older people who had recently been in hospital. The survey was designed to gain an insight into whether the standards for nutritional care in acute hospitals are being met. A summary of the survey findings are presented.

Journal article

Eat, drink and be healthy: malnutrition on the wards

Author:
TAYLOR Jennifer
Journal article citation:
Health Service Journal, 4.6.09, 2009, pp.22-23.
Publisher:
Emap Healthcare

The health of many older patients in hospital is being jeopardised through lack of attention at meal times. This article provides some tips on how to ensure older patients eat properly. These include a short case study which outlines a volunteering programme at Darlington Memorial Hospital.

Journal article

Improving nutrition for older people in hospital by assessing current practice

Authors:
MAUD Rebecca, WEBSTER Jonathan
Journal article citation:
Nursing Times, 10.2.09, 2009, pp.18-19.
Publisher:
Nursing Times

Malnutrition is a major challenge in acute care. This article outlines the development of an audit tool too improve nutritional care for older people on an acute admissions unit. The aim was to examine current practice, identify aspects of good practice and areas for improvement. The audit's outcomes are also reported.

Journal article

Dazed and confused: making sense of delirium after hip fracture

Authors:
HARDING Rebecca, MARTIN Carol, HOLMES John
Journal article citation:
International Journal of Geriatric Psychiatry, 23(9), September 2008, pp.984-986.
Publisher:
Wiley-Blackwell

Delirium is a common complication in general hospitals associated with negative outcomes, including longer hospitalisation and fractures from falls while wandering. This small scale study interviewed nine older people about their delirious experiences. The interviews were analysed using Interpretative Phenomenological Analysis (IPA), enabling the researcher to develop a psychological understanding.

Journal article Full text available online for free

Supporting older people through a hospital stay

Author:
SOCIAL CARE INSTITUTE FOR EXCELLENCE
Journal article citation:
Community Care, 18.9.08, 2008, pp.36-37.
Publisher:
Reed Business Information

Highlights good practice when working with older people admitted to hospital.

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