Too often, family members are left to make difficult decisions about care for a loved one who is at the end of his or her life. Emotions are running high and, without clear instructions from the patient, the family may make decisions about their care that goes against the patient’s wishes. It can be difficult to think about, but making decisions about care at the end of life before someone is seriously ill or incapacitated is important. The Conversation Project helps patients, families and healthcare providers discuss end-of-life care. The project provides a toolkit to help start these conversations and consolidate the patient’s wishes in one central location. It lays out medical terminology in easy-to-understand language and answers frequently asked questions about what end-of-life care options may be available. Click here to download the toolkit and share with patients.
On May 2, AAMC held a ribbon-cutting for its Acute Care of the Elderly (ACE) unit. The ACE unit offers a specialized model of care for older, hospitalized patients with acute illness. The 30-bed unit is one of 13 in Maryland.
“Many times, highly functioning older adults are admitted to a hospital for a few days and are so weakened by the experience that they become too frail to return to their independent lives,” says Prasad Savana, MD, medical director of the ACE unit. “Our team is specially trained to better understand the risk factors for developing adverse events and will take special attention to ensure patients are moving as soon as possible to avoid complications.”
AAMC was awarded the Nurses Improving Care for Healthsystem Elders (NICHE) facility designation in December 2012 as they prepared for the ACE unit opening. The national NICHE organization strives to improve the quality of care for hospitalized older adults, provides evidence-based geriatric protocols and geriatric education for hospital staff members so they are better equipped to care for older adults. NICHE is the largest geriatric nursing program available in the United States, with nearly 300 participating hospitals.
“Geriatric patients face a variety of health risks. This model of care has proven that focusing on the unique needs of the elderly enhances clinical outcomes during and following hospital admission,” says Sherry Perkins, PhD, RN, AAMC’s chief operating officer and chief nursing officer.
Patients admitted to the ACE unit will be seen by their attending physician and will receive consults from members of a special team that includes a geriatrician or geriatric nurse practitioner, dietitian, pharmacist, social worker, case manager, physical therapist, spiritual care, as well as auxiliary volunteers. Patient-and-family advisors will be active participants in the patients’ care plan, providing guidance to team members. Under the direction of this team, ACE patients will be gently pushed to maintain their strength and routine from the time they are admitted until their discharge.
The medical surgical unit at Anne Arundel Medical Center (AAMC) recently received a Circle of Honor Award from the Maryland Patient Safety Center. The Center recognizes hospitals and health systems for their progress in advancing a culture of safety for patients, families and staff.
AAMC’s medical surgical unit won the award for their work in preventing catheter-associated urinary tract infections (CAUTI). If left untreated, CAUTIs can lead to more serious kidney infection and contribute to health decline in patients with compromised immune systems.
“We are always looking for ways to eliminate preventable harm for every patient,” says Christine Frost, RN, AAMC’s director of the medical surgical unit. “The model we developed for prevention resulted in a full year with no infections and the positive trend continues.”
The medical surgical unit CAUTI team used evidence-based practices and rounded with nurses and staff each month conducting situational analysis regarding patients. The team worked closely with infection control to review trends and develop plans for catheter removal, a key factor in their success.