An age related acute medical unit – Creating an age-attuned model of acute care

Title : An age related acute medical unit – Creating an age-attuned model of acute care

Abstract:

Background
Multi-morbidity increases with age and older adults are more likely to present to acute hospital services with complex health states/Geriatric syndromes. For people with underlying physical or cognitive illnesses, these issues can be compounded by the built environment of acute hospitals. Meeting the needs of a growing frail older population is a key challenge for acute hospital services. 
The main aims of this development quality improvement project were to create a dedicated Age-related acute medical unit using the concept of universal design and with dedicated Gerontological staffing including a Registered Advanced Nurse Practitioner (RANP) in Gerontology.
Methods
A project team was convened with representation from Geriatric nursing, Geriatric Medicine, Health and Social Care Professionals (HSCP), Estates, Technical services and the executive management team. An appropriate area was identified on the acute floor which was co-located with a newly developed Acute Medical Unit. Using a universal design approach, a 4-cubical Age Related Assessment Unit (ARAU) including a dedicated multidisciplinary assessment room was created. The role of the RANP in Gerontology for ARAU was developed to provide comprehensive geriatric assessment to older medical patients presenting to unscheduled care. 
Results/Conclusions
Following the implementation of the ARAU there has been a 40% increase in the number of unscheduled older patients (>65’s) assessed in the Acute Medical Unit (Q1 2019 to Q1 2023). Operating within a defined scope of practice, the RANP in ARAU/AMU provides advanced specialist geriatric nursing skills and knowledge allowing for the identification of medical, psychosocial and functional needs of older adults for older adults who present to unscheduled care with common geriatric syndromes. 

Audience Take Away Notes:

• The impact of attending unscheduled care on older adults and their underlying comorbidities
• The positive impact of applying dementia friendly design to a dedicated ARAU 
• The positive impact of an RANP in Gerontology lead service in unscheduled care

Biography:

Louise Kelly commenced her nursing training in 2000 in Tallaght University Hospital (TUH) and Trinity College Dublin (TCD). Throughout her nursing career she has worked predominantly on the acute floor/unscheduled care setting. She has completed a post graduated diplomas in emergency nursing (2009) and gerontology (2016) in TCD, a masters in nursing (2019) through Royal College of Surgeons Ireland (RCSI) and most recently completed her post graduate diploma in advanced practice/prescribing (2022) via TCD. She is currently based in the newly established Age Related Assessment Unit (ARAU) on the acute floor of TUH, the first unit of its kind in Ireland. Louise was awarded The Mary O’Connor Award for Excellence in Emergency Nursing in 2021 for her work on pressure ulcer detection and prevention in emergency patients. She has presented at the Irish Gerontology Society and the All Ireland Integrated Care conferences and is the nursing lead for the National Frailty Education Programme for TUH and its community health area.