Comprehensive Care – Minimising Harm
The Older Persons' Patient Safety program has developed a safety model Comprehensive Care – Minimising Harm, which puts the focus on how we safely care for older people in hospital especially those with frailty, cognitive impairment and decreased mobility. The model ensures patient, family and carer experiences and outcomes are at the centre of our clinical care. There will be a shift to identifying individual patient risk factors and implementing patient focused interventions (fall and pressure injury risks have been included in the model as component of safe care).
It incorporates team safety fundamentals and clinical care actions that address patient fundamental care needs. It is anticipated that through improved focus on minimising harm there will be overtime a reduction in hospital acquired complications such as falls, pressure injury, delirium, malnutrition and infection (urinary tract infection and pneumonia).
There is an emphasis on quality improvement for older persons' safety and a web-based toolkit to guide commencing a Quality Improvement (QI) initiative.
What matters to me?
- Plan care in discussion with patients and families/carers
- Consider patients goals of care and preferences
- Discuss and explain patient safety risks – e.g. falls, delirium, pressure injury
- Screen for cognition
- Screen for Delirium,
- Prevent, identify, treat and manage delirium
- An older patient may have a dementia and/or depression
Safe and early mobilisation
- Patients out of bed where possible– sit in chair, march on spot, walk to end of bed/toilet
- mobility plan in place
- Identify an area that is safe for the patient to walk with family or staff
- Mobility equipment within reach
Hydration and nutrition
- Enable access to meals
- Assist with meals and opening food packages
- Prompt to drink water
- Malnutrition - promote protein