Fewer elderly people die after an acute hospital admission when a community care registered nurse is actively involved in the after-care. The mortality rate is forty percent lower than for elderly people receiving regular after-care. These are the results of research carried out by professor of geriatrics and geriatric medicine Sophia de Rooij of the University Medical Center Groningen, and Bianca Buurman of the Academic Medical Centre, Amsterdam. They have published an article on the subject in today’s edition of the scientific magazine JAMA Internal Medicine.
On getting home from hospital after an acute illness (such as acute pneumonia), many elderly people find themselves unable to perform routine tasks: they may suddenly experience problems with activities such as washing themselves, getting dressed or shopping. It takes an average of three to six months for an elderly person to recover completely. However, a quarter to a third of these people die within three months of being discharged after an acute hospital admission.
Research by De Rooij and Buurman reveals that although intervention by a community care registered nurse does not reduce the loss of functions experienced by elderly people, it does lead to fewer deaths among this group. The researchers monitored a large group of elderly people who had been admitted to hospital with an acute illness. On being discharged, half of them were given regular after-care and the other half were cared for through a Transmural Bridging Care programme, in which a geriatric team from the hospital and the community care registered nurse played an important role.
The community care registered nurses in the care programme were introduced to elderly patients while they were still in hospital. On being discharged, the community care registered nurses made several home visits to patients to discuss their health and ask about more practical matters such as essential aids around the home, medication and contact with the GP and home care service.
Considerably fewer members of the group receiving care from the Transmural Bridging Care programme died than in the control group receiving regular after-care. De Rooij: ‘The information that patients are given on being discharged from hospital can be overwhelming and many of them do not know exactly what they are supposed to do when they get home. Seeing a community care registered nurse gives them an opportunity to ask any questions they may have about changes to their medication, for example. This research shows that a district nurse can make all the difference.’
At present, 25 hospitals in the Netherlands are running the care programme. Several healthcare insurers have also included the programme in their procurement guide. De Rooij will conduct a follow-up study among patients from the UMCG, the Martini Hospital, the Ommerlander Hospital Group (OZG) and a number of other hospitals.
Transmural Bridging Care is part of the National Geriatric Care Programme, a government programme aimed at improving the healthcare for frail elderly people.
A PhD dissertation consisting of more than 1100 pages and covering a total of 31 chapters. UMCG PhD-candidate Arno Bourgonje (26) probably wrote the most voluminous medical PhD dissertation ever published in the Netherlands.
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