Title : Advanced nurse practitioner - Supported nursing home liaison service
Abstract:
Nursing Home Residents (NHR) are the frailest group of older people in society and require a gerontologically attuned approach to address multiple challenges presented to the practitioner.
In 2018 we commenced an advanced nurse practitioner (ANP) specialist liaison service with bespoke comprehensive geriatric assessment to support NHR admitted a tertiary referral university teaching hospital. Given the impact of COVID-19 on NHR in particular, this service was expanded to include a consultant physician and specialist registrar in geriatric medicine, when full care of NHRs came under geriatric medicine services. This also includes a two-week post-discharge virtual clinic with Nursing Home director of nursing and/or GP.
Methods:
Information on all NHRs attending a tertiary referral university teaching hospital was collected from 2018-2023. Data on demographics, presenting complaints, CGA assessment, and outcomes on length of stay, emergency department recidivism, and mortality were collected. Impact on clinical outcomes of liaison care versus full geriatric medicine care are presented in this abstract
Results:
As result of the enhanced care model where full inpatient governance came under the geriatric medicine services we observed:
• Readmission rate 37% (2018) vs 12.7% (2021)
• Reduction in Length of Stay from 2018-2021 from 11%-10%
• Halved the overall bed-usage days from 2018-2021
Conclusion:
The high complexity of this cohort of patients requires a timely, comprehensive gerontological approach in order to provide holistic care. Better care with CGA embedded also translates to better use of acute hospital resource.
Audience Take away Notes:
- How to develop a nurse led service to ensure nursing home residents receive appropriate direct gerontological care while in the acute hospital to cater for their specific needs.
- This service is specific to nursing home residents care to enhance their journey through the acute services . it has grown and developed to reflect a true hospital without walls ensuring the resident get the right care in the right place at the right time.
- The importance of having specific pathways for older people in an ageing population
