Prevention of functional decline in older hospitalized patients: Nurses should play a key role in safe and adequate care

Authors

  • Jita G Hoogerduijn RN PhD,

    Associate Professor, Corresponding author
    1. Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
    • Correspondence: Jita G. Hoogerduijn, University of Applied Sciences Utrecht, Bolognalaan 101, 3584 CJ Utrecht, The Netherlands. Email: Jita.Hoogerduijn@hu.nl

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  • Diederick E Grobbee MD PhD,

    Professor
    1. Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
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  • Marieke J Schuurmans RN PhD

    Professor
    1. Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
    2. Department of Rehabilitation, Nursing Science and Sports, Utrecht University, Utrecht, The Netherlands
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  • No funding.
  • No conflict of interest.

Abstract

This paper presents a discussion of knowledge and awareness regarding prevention of functional decline in older hospitalized patients.

Functional decline is experienced by 30–60% of the older hospitalized patients, resulting in decreased independence and other adverse health outcomes.

One literature study and four cohort studies (total n = 1628) were conducted to develop and validate an instrument to identify older hospitalized patients at risk for functional decline. An evidence-based best practice was developed to improve the quality of care for older patients.

This paper shows the relevance and the complexity of this problem and shows that patients at risk can be recognized by four simple questions.

Due to their ability to observe and guide patients and their 24-h patient supervision, nurses should play a key role in strategies to prevent functional decline. Nurses should assess the geriatric needs in patients at risk and based on these initiate and coordinate multi-professional interventions. Given the growing number of older people in western society and the growing need for care, action to prevent functional decline cannot be withheld. Knowledge of the ageing process, implementation of an evidence-based programme and a multidisciplinary approach is a basic ingredient to prevent functional decline.

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