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Explore the outcomes of nutrition and continence programs in geriatric units, with insights into continuous quality improvement and screening tools. Discover the College for Geriatrics' initiatives and partnerships.
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College for Geriatrics1. State of the Art2. Projects’ resultsJean-Pierre Baeyens on behalf of the College for Geriatrics
State of the art (1) • Peer review 2000: 103/160 geriatric units • 13 admissions/bed/year (median) • 50% admissions from private home • 46% home discharge • median age = 82 yrs • length of stay 22 days • median occupation rate 90% • multidisciplinary team J.P.Baeyens et al. BVGG 2000
State of the art (2) • 21 formation centers • 37 fellow places available http://www.health.fgov.be/AGP/fr/professions/medecins/maitre_de_stage/specialites/geria.htm
College ’s projects • 2000: peer review • 2001: nutrition • 2002: continence, emergency, radiotherapy • 2003: BMDS, AGGIR, ... • collaborations with the Colleges for: • radiotherapy • nephrology • emergency medicine
OUTCOMES OF CONTINUOUS PROCESS IMPROVEMENT OF NUTRITIONAL CARE PROGRAM AMONG GERIATRIC UNITS IN BELGIUM Nutrition program 2001
Observation comprehensive geriatric assessment and MNA routine nutrition Intervention comprehensive geriatric assessment and MNA « Flow Chart» « Meals on Wheels » approach Methodology: 2 phases 0 3 6 months Nutrition program 2001
Conclusions • high prevalence of malnutrition among geriatric hospitalized patients • significant decreased hospitalization stay during 2nd phase (confounding factors ?) • significant increased PAB concentrations during 2nd phase J Gerontology 2004, In Press Nutrition program 2001
DRIPDetect, Reduce, Incontinence, Programme Thierry Pepersack on behalf of the College for Geriatrics
Discussion • 45% of incontinent patients in geriatric units • 26% of transient incontinence • functional incontinence represents more than half of the chronic situations • incontinence is associated with: • high length of stay • high proportion of demented patients Continence 2002
Rationale • the belgian geriatric program is associated with the obligation of continuous registration of quality variables • the ministry intends to ask us this registration • the College for Geriatrics and the Belgian Society for Gerontology and Geriatrics think it would be better to choose ourselves these variables among the comprehensive geriatric assessment
Worksheet • Part I:2003 - questionnaire about Comprehensive Geriatric Assessment • Part II:2004 - consensus conference "Belgian Minimum Geriatric Screening Tools » • Part III:2005 - topics choice
Part I Belgian Minimum Geriatric Screening Toolsfor Comprehensive Geriatric Assessment College for Geriatrics www.geriatrie.be
Results • 59 questionnaires • acute and subacute G beds
Comprehensive Geriatric Assessment • ADL • IADL • risk of falling • cognition • depression • social • nutrition • pain • QOL already used proposed for BMGS
ConclusionsPart I • response rate • geriatricians : interested in CGA • transparency of geriatric units quality of questionnaire not enough CGA lack of uniformity CGA ~ no consensus
Part II 2004Consensus Conference "Belgian Minimum Geriatric Screening Tools » College for Geriatrics www.geriatrie.be
Working groups ADL-IADL P De Vriendt, G Dargent, C Swine MobilityJP Baeyens , Ghesquière CognitionM Lambert , E Gorus, C Sachem DepressionA Velghe, Th Pepersack Social JP Baeyens, H Vandekerkhof Nutrition T Pepersack, H Daniels,J Pétermans, C Gazzotti Pain N Vandennoorgate, A Pepinster FrailtyC Swine, G Dargent, P De Vriendt www.geriatrie.be
Part III2005Topics choice College for Geriatrics www.geriatrie.be
Priorities • geriatric programme • programmation of beds • adapted financial ressources • alternative services • day hospital • inpatients geriatric consultation service (multidisciplinary) • for geriatric problems (confusion, denutrition, falls, incontinence, etc.)
Objectives quality partnership « education » and awareness campaign promotion of a broader health concept Ressources advisory board scientific society surveys (nutrition, continence, SEGA) comprehensive geriatrics focused on: maintenance of function and comfort presence of satisfactory support systems College ’s role