Abstract
Background & Objectives
Research suggests that specialized education for nurses decreases frailty and improves functionality in hospitalized older adults. This study explored the impact of a specialized geriatric education program on mobilization rates for older adult patients in acute care in 5 hospitals.
Methods
A mixed methods approach with pre- and post- intervention questionnaires (Geriatric In-hospital Nursing Care Questionnaire (Ger-INCQ) and study specific knowledge assessment) was used to explore facilitators and challenges of caring for older adults, the knowledge base and experiences of staff, and the impact of providing specialized education. Acute care nursing staff participated in a 4-hour education intervention focusing on the Geriatric 5Ms (Mind, Mobility, Medications, Multi-complexity and Matters Most) and frailty prevention. Patient level data was collected through mobility audits (I-MOVE) and observation of shift handover communication. Semi-structured interviews with staff were completed to explore the results of the questionnaires.
Results
Registered nurses, licensed practical nurses and personal care attendants (N=64, Mean age=36.9, 87% female) who participated in the specialized training did not show significant change in their assessment scores. Patient (N=99, mean age=76.2, 54.5% female ) mobilization did not differ between phases of intervention (p=0.08), nor was there any significant change in reporting mobility at shift handover. Ger-INCQ indicated neutral responsibility for falls incidents and retention of patient mobility, with interviews (n=26) revealing that patients are kept immobilized for safety and workload management.
Conclusion
Staff had positive attitudes toward caring for older adults; however, their understanding and application of geriatric principles were limited and remained unchanged. Interview participants stated their work environment limits their capacity to deliver the best practice care presented in the education sessions. These findings suggest that education alone is unlikely to influence prioritization of mobility for frail older adults in a strained acute care setting.
Comments
This is a very interesting poster - a little bit sad that the education did not make any positive difference. I guess all change needs to be embedded within supportive systems.