Cross-sectional analysis of geriatric care models

introduction
Studies have shown that reduced physical activity in older patients is associated with an increased risk of death and complications and is positively associated with length of hospital stay, in-hospital falls, pressure ulcers, surgery, and hospital admissions (Shinall et al., 2020). Nevertheless, scholars suggest that frequent frailty assessment and identification of relevant risk factors will help clinical medical staff to detect patients' frailty as early as possible and provide effective care. Meaning (Wang et al., 2022). The ward is an orthopedic emergency ward,
Most of the patients are from the World Health Organization. According to the analysis of 9 abnormal falls and retrospective medical records in the unit that year (2020), the incidence rate in the current month (September/3rd) was 0.03%, most of which were due to weak constitution and repeatedly faced multiple and complex diseases For elderly patients with high levels, nursing colleagues feel endless power in nursing, which stimulates the motivation of the research group, hoping to improve the ability of nurses to assess the degree of decline in physical ability of elderly patients through this project
.
The purpose of this project is to improve the rate of impairment of nurses' impairment of frailty in elderly patients, the performance rate of corrective assessment, and the correct rate of high-risk frailty assessment. Referring to the literature on the hazards of frailty and weakening education (Leblanc, A., 2022), the target is 81.0%. Therefore, the target value for orthopedic nurses to assess the frailty of elderly patients is set at 53.5% to 81.0%; the implementation rate of physical frailty tools refers to medical centers at the same level 100% target completion rate in relevant benchmark literature (Xie et al., 2021); according to the technical audit specification goals of the Ministry of Nursing, the accuracy rate of weak and high-risk audits is 90.0%,
method

Strategies to improve nurses' ability to assess frailty in advanced age include:

Educate nurses on interventions to improve frailty awareness,
Build a frailty assessment tool,
Normalize the weak and weak,
Establish a weak, weak and high-risk review mechanism

result

During the project period from October 1, 2021 to January 31, 2022, the project team formulated standardized operating procedures and guidelines for the elderly care. They also designed audit forms to assess the effectiveness of these programs. The significant work on orthopedic nurse competency evaluation improved the correct recognition rate of elderly patients with decreased physical function from 53.5% to 93.0%, achieving the project goal.

From April 15, 2022, the Continuous Frailty Scale (CFS) assessment will be implemented. Statistical analysis was performed on CFS records of elderly patients admitted and discharged between October 1, 2022, and January 30, 2023. The evaluation period is ongoing and performances are underway, in addition, the execution rate has reached 100%, and the goals of the project have been achieved.

The project team also collaborated to establish a vulnerability assessment review mechanism and designed an assessment plan. From October 1, 2021 to January 31, 2022, there will be significant improvement in the evaluation of nursing staff's ability. The accuracy rate of the vulnerability assessment increased from 56.9% to 96.5%, meeting the project goal.

Analysis of the data showed that patients with a frailty scale score of 5 or more showed significant improvement. However, by following the guidelines and protocols for geriatric care, a discharge readiness team was activated to assess discharge care. The project team conducts statistics on the referral rate of patients every month. As of January 30, 2023, the recovery potential rate of referred cases has increased by 20 percentage points. 100% discharge readiness and post-acute care (PAC) referrals

in conclusion
Through education and training, the introduction of the Clinical Frailty Scale (CFS) and routine corrective assessment, nurses have a higher impairment rate, implementation rate of frailty assessment and frailty accuracy rate in physical function assessment. - I improved Risk Audit.

thank you

We sincerely thank the Taiwan Shin Kong Medical Foundation Shin Kong Wu Heshu Memorial Hospital for its donation, and the cross-teams in orthopedics, geriatrics, and rehabilitation for their valuable cooperation and support throughout the research process. We are very proud to announce that the hospital has donated the International Medical Quality Management Advanced Award.

reference literature
Xie Yuping, Qiu Jinkuai, Wang Shumei, Chen Lihua, Wen Yuren (2021). Elderly comfort, silver-haired newborns, elderly patients frailty assessment and fall prevention improvement plan. Health Promotion Research and Practice, 4(1), 161-168.
Leblanc, A., Diab, N., Backman, C., Huang, S., Pulfer, T., Chin, M., Kobewka, DM, McIsaac, DI, Lawson, J., and Forster, AJ (2022). To develop and evaluate educational interventions to increase awareness of frailty in acute respiratory care units. BMJ Open Quality, 11(3), e001935.
Soliman, C., Thomas, BC, Santaguida, P., Lawrentschuk, N., Mertens, E., Giannarini, G.... and Furrer, MA (2022). Active participation of nursing staff in the reporting and grading of complication events--Protocol and results of the CAMUS-focused Nurses Delphi Study. BJUI Compass, 3(6), 466-483.
Shinall, MC, Arya, S., Youk, A., Varley, P., Shah, R., Massarweh, NN... and Hall, DE (2020). Preoperative patient weakness and surgery should be followed JAMA Surgery, 155(1), e194620-e194620. king
D., Yin, P., Li, Y., Chen, M., Cui, X., Cheng, S., ... and Tang, P. (2022). Frailty factors and outcomes in patients undergoing orthopedic surgery: a protocol for a systematic review and meta-analysis. JMIR Research Protocols, 11(4), e28338.