European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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criteria for diagnosis clearer, and highlight the danger of treating
asymptomatic bacteriuria. We also intend to pilot removing leucocytes
and nitrites from our urine dipsticks to reduce over-diagnosis based on
these results which have a poor positive predictive value in older
people. We will evaluate the effect of these measures using a quality
improvement programme.
P-028
A survey study on perceptions and attitudes of nurses and nursing
aides toward oral and body hygiene for hospitalized geriatric
patients
E. Janssens 1, E. Steeman2, K. Milisen1,3. 1Department of Public Health
and Primary Care, KU Leuven, University of Leuven, Academic Centre for
Nursing and Midwifery, Leuven, 2Nikolaas General Hospital, Sint-Niklaas,
3Department of Internal Medicine, Division of Geriatric Medicine,
University Hospital Leuven, Leuven, Belgium
Introduction: Many nurses perform body hygiene for geriatric
patients on a daily basis while the performance of oral hygiene is
often skipped. Insight into perceptions of caregivers toward personal
hygiene for geriatric patients might help in setting up strategies to
improve nursing care for oral and body hygiene.
Methods: The Personal Hygiene Perceptions and Attitudes Question-
naire was developed, validated and distributed to 312 nurses and
nursing aids of a non-academic general hospital.
Results: Most commonly reported barriers in performing oral hygiene
were “Patient’ s resistance” (53%) and “Not enough time” (37%). This
was 37% and 6% for body hygiene, respectively. Overall 49% and 20%
experienced no barrier for body hygiene and oral hygiene, respectively.
Oral hygiene and body hygiene was a priority in 88% and 97%,
respectively. For all different oral care interventions, at least 75% of the
caregivers agreed on the statement “I have enough knowledge about
this specific care interventions” and “I think this care aspect of oral
care is important ”. Only 21% performed oral care interventions
according to the recommended frequency. 100% indicated that they
had sufficient knowledge about all different nursing interventions for
body hygiene and considered these interventions as important.
Conclusions: Nurses give more priority to body hygiene at the
expense of performing oral hygiene. Oral care isn ’ t performed
according to the recommended frequency, most likely because of the
perceived barriers.
P-029
Contrast induced nephropathy in elderly patients undergoing CT
pulmonary angiogram
P. Jarvis, D. Tiwari, M. Vassallo. Royal Bournemouth Hospital
Background: The demand for acute admissions has risen relentlessly.
Early discharges are now a feature of many admissions. The risk of
contrast induced nephropathy (CIN) is around 2% with normal renal
function, this is much higher when patients have additional risk
factors such as diabetes, heart failure and being aged over 75 years. We
studied the incidence of CIN following in-patient CTPA in older adults
in order to develop guidelines for the ambulatory care environment.
Method: Retrospective audit of 80 patients aged over 80 years having
an inpatient CTPA at Royal Bournemouth Hospital over 4 months.
Additional risk factors for each patient were sought. Baseline, pre and
post contrast renal function was assessed. The number of patients
developing acute kidney injury (AKI) after contrast administrationwas
identified and pre and post exposure preventative strategies were
assessed in all patients. The definition of AKI used was either a serum
creatinine rise by ≥26 μmol/L within 48 hours or a serum creatinine
rise ≥1.5 fold from the baseline value.
Results: 75% of patients studied had at least 2 identifiable risk factors
for CIN. 27.5% (22/80) of patients had no blood tests following
CTPA. Of the remaining patients 12% (7/58) had an AKI on post contrast
blood tests. 72% (53/74) of patients did not receive pre CTPA hydration.
Conclusions: Elderly patients are at greater risk of AKI following CTPA
and follow up blood tests should be requested. Additional risk factors
for CIN should be identified pre CTPA and I.V. hydration given if
appropriate.
P-030
Elderly people readmitted to hospital for acute medical
care – implications for occupational therapy
M. Jönsson1, P. Appelros2, C. Fredriksson 3. 1Department of Medicine,
Örebro University Hospital and School of Health Sciences, Örebro
University, 2Department of Neorology, Örebro University Hospital,
3Department of Health and Medicine, School of Health Sciences,
Örebro University, Örebro, Sweden
Introduction: Being old and visiting acute care several times has been
shown to be more than a medical problem. Aging individuals often
have a vulnerable life situation, with physical frailty combined with
mental disorders. In occupational therapy it is important to assess and
describe the elderly patients’ ability to perform activities of daily living
(ADL) and cognitive function. The aim is to describe ADL, cognitive
function but also the risk for pressure sores, malnutrition and falls in
this group.
Methods: This was a comparative study, where data were collected
during four months. Persons 75 years, were assessed on one occasion
by an occupational therapist using the ADL-taxonomy and the MMSE.
Risks for pressure sores, malnutrition and falls were assessed using
Risk Assessment Pressure Sores, Mini Nutritional Assessment, and
Downton Fall Risk Index. External data was used for comparison.
Results: 60 persons were included, mean age was 84 years. The
patients had a median of 4 diagnoses. Mean hospital stay was 5 days.
Most patients were independent in food intake. There was a high
degree of dependency in other ADL activities. Nineteen of 48 patients
had 24 point or lower in MMSE. Compared to an age-matched sample,
these patients showed a higher risk for pressure sores, risk for falls and
dependency in ADL.
Conclusion: There is a need for assessments of ADL, cognition, risk for
falls, and pressure sores in older people who are readmitted to
hospitals. Such assessments, and necessary interventions taken, may
prevent unnecessary admissions.
P-031
Is it possible to use physical-functional tests in an emergency
department?
B. Bæksted Jørgensen1, M. Gregersen1, E.M. Damsgaard 1. 1Department
of Geriatrics, Aarhus University Hospital, Aarhus, Denmark
Objectives: The use of physical-functional tests in geriatric patients
acutely admitted to an emergency department (ED) needs to be
examined to ensure that appropriate measures are provided when a
functional decline is demonstrated. The aim of this study was to
examine the feasibility of the “DEMMI-test”, the “30-s chair stand test”,
and the “Modified 30-s chair stand test” which allows use of arm rests.
Methods: Twenty-five community-dwelling 75+ years old adults
admitted to an ED during a period of 30 days. On random days the
patients with the most frequent geriatric diagnoses: pneumonia,
urinary tract infections, other infections, delirium, constipation,
anemia, COPD, dehydration, and heart failure were selected. The
patients were tested by the three physical-functional tests on the first
day of admittance and prior to transfer to a geriatric ward or discharge.
The tests were part of a comprehensive geriatric assessment in the ED.
They were performed by a trained physiotherapist and carried out on
the patient’s room and the hospital hallway.
Results: The patients’ mean age was 88.4 years (±4.3), (range 84– 95).
Sixty percent were women. The “DEMMI-test” could be performed
in 72% of the patients, the “30-s chair stand test” in 20% and the
“Modified 30-s chair stand test ” in 30%. Severely impaired cognitive
function, pain, unconsciousness, and severe osteoporosis made the
tests unfeasible.
Conclusion: Only the “DEMMI-test” may be feasible in an emergency
department to identify functional decline in very old geriatric patients
with acute illness.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S36