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G.A. Rollandi




Department Geriatric Care, OrthoGeriatrics and

Rehabilitation, E.O. Galliera Hospital,


Clinical Trial Unit, Scientific

Direction, E.O. Galliera Hospital, Genoa,


Department of Information

Technology, Bioengineering, Robotics and Systems Engineering, University

of Genoa,


Department of Sciences for Architecture, University of Genoa,



About 8% of hospitalized older patients prolong

their hospital stay despite being fit for discharge from the hospital

with an increased risk of disabilities and iatrogenic diseases due to

the prolonged hospital stay. Aim of this project was to create an

innovative model of protected discharge area equipped with auto-

mated monitoring technologies and architectural features in order

to prevent deterioration, improve autonomy, mobility and quality of

life (QOL).


Hospitalized frail older patients who are fit for discharge

but cannot return home for non-clinical reasons were included.

The high-tech integrated systems included health monitors (heart

rate, blood pressure, pulse-oximetry, glucometer, body weight),

environmental sensors (cameras, RGB-D sensors), wearable devices

(accelerometers, localization tags) and an assistive robot (PadBot)

for older people. The data acquired were processed and modeled

by a software platform which includes a variety of data analysis

tools to ensure the safety of the older persons, by monitoring their

activities and degree of independence. In all subjects functio-

nal (ADL, IADL) and cognitive (SPMSQ) status, Multidimensional

Prognostic Index (MPI), the Quality of Life (SF12) and satisfaction

were also recorded.


Ten older subject (Male = 4

Female = 6, mean age = 77.4


7.8 years) were included. The mean length-of-stay was 4.4+/


days. No significant changes occurred in functional, cognitive and

multidimensional parameters; QoL increased and satisfaction was



These preliminary data suggest that the MODIPO model

may be effective in promoting early discharge from the hospital, by

maintaining functional and cognitive abilities and improving QoL in

frail older subjects.


Spread the word: first geriatric unit in Portugal

F. Rocha


, R. Martins


, E. Haghighi


, J. Barata




Geriatric Unit, Internal

Medicine Department, Hospital Vila Franca de Xira, Portugal


The hospitalization of the elderly patient is often

associated with a functional decline and increased dependency. A

comprehensive geriatric assessment (CGA) in this setting has proven

its benefits by preventing or attenuating this decline. In order to

improve the quality of care provided to the elderly patient, Hospital

Vila Franca de Xira has founded a Geriatrics Unit.


The Geriatrics Unit of Hospital Vila Franca de Xira is a pilot

project designed according to international models. Admission criteria

of inclusion and exclusionwere defined and disclosed to other hospital

health care professionals.


The Geriatrics Unit is composed by 12 beds on the Internal

Medicine ward. Patients can be admitted through the emergency

department, external consult or be transferred from other wards.

The rooms are being equipped with distinctive objects such as

big clocks on the wall and mini steppers to enhance mobility and

prevent functional decline. As for human resources the multi-

disciplinary team is being trained and includes attending physicians,

nurses, a physiotherapist, a nutritionist, a psychologist and a social


Key conclusions:

Adapting health care to the elderly people specific

needs is essential due to the aging of our population. Unfortunately

in Portugal this approach is still underused. This pilot project intends

to approach the patient based on the CGA in order to improve the

quality of life of the Portuguese elderly patients. It is time to spread

the word and implement this kind of units in a country where 19% of

the population is elderly.


Nurse staffing and elderly patient mortality in acute care hospitals:

a longitudinal study

C. Rochefort


, L.-A. Audet


, D. Buckeridge


, M. Abrahamowicz




University of Sherbrooke,


McGill University


Recent cross-sectional studies have suggested that

certain nurse staffing policies (e.g., using overtime hours or hiring

less qualified staff) may be associated with an increased risk of patient

mortality in acute care hospitals. This longitudinal study aimed to:

(a) further examine these associations in elderly patients and, (b)

determine if optimal staffing thresholds can be established.


A dynamic cohort of elderly patients (

65 years) admitted

to a Canadian university health network between January 2010 and

December 2014 was followed during the inpatient stay. Patient

exposure to two commonly used staffing policies was measured: (1)

overtime hour use and, (2) skill mix (the proportion of Registered

Nurses among the nursing staff). Cox regression models were used to

examine the association between these staffing policies and the risk of

patient death while adjusting for severity of illness and other risk

factors. To detect any staffing thresholds, flexible non-linear spline

functions were fitted.


Over the study period, 5,729 (4.5%) deaths were observed. In

multivariate analysis, every 5% reduction in skill mix per patient was

associated with a 5% increase in the risk of patient death (HR, 1.05; 95%

CI: 1.04

1.06). Similarly, every 5% increase in the proportion of

overtime hours per patient was associated with a 3% increase in the

risk of patient death (HR, 1.03; 95%CI: 1.01

1.05). No specific staffing

threshold could be identified.


The findings of this study strongly suggest that improve-

ments in patient safety require a sufficient supply of adequately

trained Registered Nurses at bedside.


Smart medication dispenser

a new device to improve medication

adherence in older people

A. Santos


, D. Sofia


, N. Santos


, R. Nunes




Hospital de S. Francisco



Instituto Superior Técnico, Lisboa, Portugal


Multimorbidity and polypharmacy have become highly

prevalent amongst older people. Polypharmacy increases the risk of

noncompliance to pharmacotherapy and unintended medication

errors due to high complexity medication regimens, especially in

cognitively impaired patients. Failure of treatment and adverse

drug reactions can occur as a result of poor medication adherence.

New technologic devices that improve medication adherence can

be useful.


Development of a prototype of a medication dispenser,

which aims to improve medication adherence, especially in older

and/or cognitively impaired patients.

Methods and results:

The features of several products already

available on the market were analysed and several restrictions

and limitations were identified. Based on this analysis, a list of

required features and the overall architecture of the solution to be

developed were defined. One of the main requirements was to

create an open solution that enables communication with other

devices (smartphones and tablets) and the connection to the

Internet, allowing it to be tailored to different contexts. Given the

emphasis in the openness and remote interaction capacity, an

Application Programming Interface has also been created, allowing

third parties to develop and optimize applications to interact with

the dispenser in specific contexts, and allowing the automation of

configuration procedures (e.g. defining the drug regimen) and the

collection of events (e.g. failed doses and access attempts in hours

not allowed).


The developed prototype fulfilled the proposed require-

ments, culminating in a modular, versatile and affordable solution,

which might improve medication adherence and consequently health

and quality of life of users.

Poster presentations / European Geriatric Medicine 7S1 (2016) S29