agreement of the IVC was 0.68, pc values ranged between 0.007
and 0.055. Modified kappa ranged between 0.86 and 1, which was
Incorporation of the CCF philosophy in the usual practice
is crucial in decreasing functional decline of OA during hospitalization.
The Portuguese version of FFCCB showed high levels of CVI, pc and MK,
supported by a panel of 7 experts. These results support the validity of
the content of this tool.
Prediction of functional decline among hospitalized older adults:
ISAR-HP content validity
, J. Grácio
, L. Nunes
Coimbra University Hospital Centre
Hospitalized older adults (OA) are at risk of functional
decline (FD). The Identi
cation of Seniors At Risk
Patients (ISAR-HP) is a screening tool to identify older patients at risk
for FD. This study
s aims were to (i) translate, adapt and validate the
ISAR-HP for the Portuguese population; (ii) evaluate content validity
index (CVI) using expert panel and fidelity (test-retest interrater).
Principles of good practice for translation and cultural
adaptation were use. The analysis of content validity included CVI,
probability of a chance occurrence (pc) and modified Kappa (MK).
The assessment was undertaken by six experts in geriatrics and
research fields. Two researchers performed the test
retest among 15
OA, through the calculation of Cohen
s kappa coefficient (CKC). SPSS
software, version 20, was used for the statistical analysis.
The preliminary version of ISAR-HP was obtained and it was
evaluated by a group of experts. The four items evaluation showed:
item 1 IVC = 0.86 and items 2, 3 and 4 IVC = 1), the average value of the
IVC = 0.97 and the universal agreement of the IVC = 0.75; pc values
ranged between 0.055 and 0.008. Modified kappa ranged between
0.81 and 1, which was considered as excellent. The average value of
CKC = 1, indicating high inter-rater agreement.
The identification of patients at higher risk is the first step
in preventing FD. The preliminary study showed that the Portuguese
version of ISAR-HP is valid and reliable to be used in clinical practice.
A retrospective study of nursing diagnosis of hospitalized older
, J. Grácio
, L. Nunes
Coimbra University Hospital Centre
Nurses have the most direct and sustained contact with
patients, as well as, an important role in the assessment of self-care
(SC). The nurses
diagnosis (ND) pertaining to self-performance is
crucial in promoting a restorative care plan. The aim of this study is to
analyze the ND of hospitalized older adult
s (OA) self-care at the
moment of admission and discharge.
Data was collected retrospectively (last trimester of 2015)
from the Electronic Nursing Documentation, of 640 OA (
n = 413 women) in four medical units of a teaching hospital. The SC
was: eating, bathing, toileting, dressing, walking, positioning and
transferring and classified in three degrees of dependency: high,
moderate and reduced. A Chi square test was performed and p < .05
considered statistically significant.
The mean age was 83.54 ± 6.49 years and the average length
of stay 9.5 ± 8 days. At admission, the majority of OA was classified as
a high level dependent in the SC, which ranged from 51.3% (dressing)
to 74.8% (eating). The discharge diagnosis was dependent of the
admission ND (p < .01). Most of the OA maintained self-performance
transferring to 98.8%
dressing) and a small number of
OA improved from admission (0.9%
dressing to 3%
transferring). However, some OA increased the dependency degree
dressing to 2.4%
Hospitalized OA sample required plenty of nursing
assistance, demonstrated by high degrees of dependency. The ND
revealed that SC remains the same between admission and discharge.
Despite little improvements, some OA lost abilities to SC, enhancing its
level of dependency.
Do older surgical patients who undergo emergency operation have
higher mortality and readmission compared to those managed
, A.D. Wood
, J. Hewitt
, L. Pearce
, S.J. Moug
, K. McCarthy
, P.K. Myint
Aberdeen Royal Infirmary,
Cardiff University, Cardiff,
Royal Alexandra Hospital, Paisley,
NHS Trust, Bristol,
University Hospital of Wales, Cardiff, UK
It is unclear whether older surgical patients who
undergo emergency operation have higher prevalence of mortality
and readmission than those managed conservatively. We therefore
examined the prevalence of emergency operations during emergency
surgical admission of older people (
65 years) and its associationwith
mortality at 90 days post- admission and hospital readmission within
30 days of discharge.
Data were employed from the Older Persons Surgical
(2013 and 2014) to assess
the prevalence of operations in older emergency surgical admis-
sions. The effect of operation on study outcomes was examined using
multivariate logistic regression adjusting for age, gender, polyphar-
macy, haemoglobin, albumin, and frailty.
A total of 727 patients [mean age (standard deviation) = 77.1
(8.2) years, 54% female] were included in this study. Of them, 185
(25%) underwent emergency operation. Patients that received an
operation were younger than those who did not [76(7.7) vs. 78(8.4)
years; P < 0.001] and higher proportion of patients were males (30.2%
vs. 23.5% in females; P = 0.006). There was no difference between
operated and non-operated patients for other characteristics exam-
ined (frailty, polypharmacy, serum albumin, and haemoglobin levels).
We found no association between operation and both outcomes:
adjusted odds ratio (AOR) (95%CI) were 0.64 (0.30
1.41; P = 0.27) and
1.77; P = 0.77) for 90-day mortality and readmission within
30 days after discharge, respectively.
A quarter patients from this cohort had an operation
during their acute surgical admission in the UK setting. There
appeared to be no impact of operation on 90 days mortality and
readmission in this population.
Stop hospital acquired pressure ulcers
, H. Al hamad
, E. Al sulaiti
, A. Darwish
, M. Kappachalil
, S. Acharath valappil
, L. Roy
, P. George
, J. Lizarus
, A. Varghees
Corporation, Doha, Qatar
A pressure ulcer is a localised injury to the skin or
underlying tissue, usually over a bony prominence, as a result of
unrelieved pressure. Pressure ulcers significantly threaten the well-
being of patients with limited mobility. 70 percent of ulcers occur in
persons older than 65 years. The female geriatric rehabilitation unit of
Rumaila hospital, Qatar provides long term care for patients over the
age of 65 with a bed capacity of 44.
The unit implemented multi component interventions or
bundled approaches to preventing pressure ulcers and that pressure
ulcer care involves physicians, nurses, and other members of the care
team. Prevention includes identifying at-risk persons and implement-
ing specific prevention measures, such as following a patient re
positioning schedule; keeping the head of the bed at the lowest safe
elevation to prevent shear; using pressure-reducing surfaces; and
assessing nutrition and providing supplementation, if needed.
There was no incidence of pressure in 2015. Health education
and constant good practice helped to prevent hospital acquired
Poster presentations / European Geriatric Medicine 7S1 (2016) S29