Article Abstract:
Focus on intervention practiced by advanced practice nurses in important when considering the McCorkle study in which older patients who went home after cancer surgery received excellent nursing care and it made a difference in how many years they lived. More older patients are being operated on and this should be studied. The intervention group had patients who had later stage cancer. The nurses used standardized protocols. They phoned the patients within 24 hours of discharge and used a standard assessment with management guidelines, measurable instructional content and a schedule for contacts. Similar study is needed in the acute care setting where the dramatic declines in nurse-patient ratio should be reversed. Quality of life must be studied as well as longevity and psychological intervention is likely a factor. Home care must be studied much more carefully.
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Article Abstract:
A randomized controlled trial of nurse case management for 427 frail subjects at least 70 years of age and at risk for repeated hospital admissions is discussed. No significant differences were found in quality of life and several other outcomes measurements. Frail older people receiving nurse case management were more likely to use emergency health services than others and that there was not a concomitant increase in health benefits.
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Article Abstract:
Medical resident training in geriatrics interdisciplinary team care for internal medicine and family practice residents is discussed. It will be necessary to change curricula for others in advanced practice such as nurses, social workers and pharmacists. Evidence-based practice outcomes show interdisciplinary team care can make a difference in patient outcome.
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