Abstract
Background
People aged over 65 years are associated with increased numbers of co-morbidities,
higher health care needs, an increased risk of fragmented care and are four times
more likely to be hospitalised than those under 65 years. Nurse Practitioners (NP)
working with older populations improved screening, clinical outcomes, patient satisfaction
and provision of equal or better care for chronically ill patients.
Aim
To evaluate the effectiveness of the NP within the Older Persons Complex Care service
to reduce hospital readmission rates in older complex patients.
Methods
A pre and post pilot study using a retrospective clinical audit of medical records
of patients referred to the NP service from January 2018 to April 2019 was undertaken.
All patients reviewed by the NP were eligible for inclusion in the study and only
those patients reviewed by the NP were included.
Findings
Seventy seven patients were referred during the reporting period. Ages ranged from
64 to 98 years, and many co-morbidities were reported; minimum of two and maximum
of 15 highlighting the complexity of the cohort. Management included education (100%),
diagnostics (62%), medication changes (61%) and referrals (49%).
Discussion
Patients managed within the service had reduced hospitalisations and many medications
were ceased, reduced or titrated by the NP. Education was a key component of care.
Conclusion
The value of NPs in the provision of care to older persons with complex, chronic diseases
was highlighted with the potential to reduce readmissions, improve quality use of
medicines and safe prescribing.
Keywords
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Article info
Publication history
Published online: July 12, 2022
Accepted:
June 29,
2022
Received in revised form:
June 7,
2022
Received:
February 2,
2022
Identification
Copyright
© 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.
