How-CGA Chapter 2: Self-assessment
You may already have a good idea about the service outcomes you wish to improve. Evidence suggests that integrating assessment and management of frail older patients into your service is more effective than having a consultation geriatric service at arm’s length.
HoW-CGA Chapter 3: Team approach to change
Designing solutions and delivering change is more effective when delivered by a core team of people who invest in engaging with a network of stakeholders. You may wish to start thinking about the advocates of improving care for frail older people in your service early.
HoW-CGA Chapter 4: Barriers to implementation
The overarching message about successful improvement shows how social relationships in organisations are key for embedding the technical features of change. A lot of time and energy in leading organisational change will require you to uncover and mitigate barriers.
Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) - History of the project
The aim of the Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) project was to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people.
Hospital Wide Comprehensive Geriatric Assessment (HoW-CGA): Overview
The aim of this project was to provide high quality evidence on delivering hospital-wide Comprehensive Geriatric Assessment (CGA). Comprehensive Geriatric Assessment (CGA) improves outcomes for frail older people, particularly on specialised wards.
Hip fracture management - plenty of guidelines, not enough evidence
Roger Jay argues that there is a plethora of guidelines governing hip fracture, but very little evidence. He contrasts this with stroke where evidence has been the focus, to good effect. Stroke has led the way - we need evidence for managing the hip fracture patient.
Evaluation of an Otago Exercise Programme and behaviour change techniques to ensure adherence
In this study, the Otago Exercise Programme is enhanced with behaviour change techniques with a view to improving adherence to home exercise in frail older people
Nursing Perspectives on the Confusion Assessment Method
The Confusion Assessment Method (CAM) is used to detect delirium but its sensitivity is low when used in real-world settings. A study explored reasons for this through a series of focus groups with orthopaedic nurses at two academic hospitals in Hamilton, Canada.
Does pain increase delirium risk in people with dementia during a hospital admission?
Alexandra Feast describes a study which highlights how people with dementia experienced pain for a substantial part of their admission without being able to communicate this pain. It explores the relationship between pain, dementia and delirium.
Mirabegron – useful for frail older people?
Henry Woodford questions the validity of using bladder anticholinergic drugs for frail older people with urinary incontinence. He says it has not been tested in frail older people and may have its own longer-term adverse effects related to adrenergic stimulation.