ISSN: 2041-6792

Clinical Investigation

Geriatric Nursing And Acute Care Online

 The Acute look after Elders (ACE) model of care was designed to scale back the incidence of functional disability of older adults occurring during hospitalization for acute medical illness. The ACE intervention was conducted on a medical–surgical unit (ACE Unit) with the target of preventing loss of independence within the activities of daily living (ADL) and to revive by the time of discharge ADL independence lost during the course of the acute illness and hospitalization. The ACE intervention used complementary principles of continuous quality improvement and comprehensive geriatric assessment in developing a replacement system of look after acutely ill older adults. A multi-dimensional intervention included four key elements: a physical environment designed to market patient functional independence and safety, patient–centered care delivered at the bedside by registered nurses together with interdisciplinary providers, comprehensive discharge planning undertaken early within the hospitalization and informed by the interdisciplinary team, and medical aid review to assure quality of medication prescribing and clinical management.   Previous publications have highlighted the risks of iatrogenic illness, adverse consequences of immobility and prolonged bedrest, and “the hazards of hospitalization”. Studies of the explanation of functional morbidity in hospitalized older patients revealed the loss of independence from baseline physical functioning to hospital discharge within the majority of older adults and highlighted the adverse consequences of hospitalization.

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