Funding sought for new project to improve basic care of elderly in hospitals

Crowd funding is being sought for a research project that will improve care of elderly patients in hospital in order to prevent common, costly complications such as UTIs and pressure ulcers.

Dr Kasia Bail, a registered nurse and Assistant Professor at the University of Canberra, is leading the project and says simple interventions of basic nursing care are under-prioritised in hospitals.

In her PhD, Dr Bail calculated that failing to maintain basic nursing care of elderly patients in NSW hospitals alone costs $225 million per year in extra length of stay.

She is now seeking to find ways to reduce the four common complications that result from what she describes as a “Failure to Maintain”: urinary tract infection, pressure ulcers, pneumonia and delirium.

“Failure to Maintain is the inadequate delivery of fundamental nursing care to a complex older person in hospital,” she said.

“The term gives a name to the challenges in providing simple interventions such as mobility, skin care, hydration, nutrition and communication in complex environments like hospitals, to complex patients such as people with dementia,” she said.

“Sometimes these conditions are called ‘geriatric syndromes’, but many of these conditions are preventable. Older, complex people are more susceptible to these conditions; my work is to highlight that with increased risk comes increased responsibility of the healthcare service to mitigate that risk.”

“We know that when demand for nursing care exceeds supply, patient care is rationed. We also know that the care most often rationed is essential cares such as mobility, skin care, hydration, nutrition and communication – this is not unreasonable necessarily as acute health settings do need to prioritise life-threatening conditions first.”

Dr Bail believes the solution is indicators of care that can be used before patients get to the life-threatening stage, particularly given that most hospital admissions include chronic, as well as acute, conditions.

“People tend to accumulate multiple conditions as we age – including cancer, diabetes, cardiovascular conditions, arthritis. So when we end up in hospital, we have multiple things that need nursing care and interventions, not just one,” she said.

“These are assumed to be ‘simple’ care interventions, but in fact, when someone is acutely unwell, on multiple medications and treatments, with multiple diseases or age-related conditions, and in a busy hospital with multiple competing and life-threatening priorities, these ‘simple’ care interventions can be very difficult to provide.”

In her PhD Dr Bail found that people with dementia spent eight times longer in hospital that people without dementia, while acquiring a complication in hospital increased costs for people with dementia by 26 per cent and those without by 100 per cent.

Her work now is focused on finding ways to better use the masses of data already collected by hospitals and refining the methods used to make it more useful in forming policy decisions about care.

Click here to support Dr Bail’s project before it closes on Friday 16 December.


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