Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals: A scoping review
Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals: A scoping review☆
Mieke Deschodt1,Email the author Mieke Deschodt, Veerle Claes1,2,Email the author Veerle Claes, Bastiaan Van GrootvenEmail the author Bastiaan Van Grootven, Koen Van den HeedeEmail the author Koen Van den Heede, Johan FlamaingEmail the author Johan Flamaing, Benoit BolandEmail the author Benoit Boland, Koen Milisen'Correspondence information about the author Koen MilisenEmail the author Koen Milisen 1Joint first authorship.
2Present address: Institute of Nursing Science, Faculty of Medicine, University of Basel, Bernouillistrasse 28, CH-4056 Basel, Switzerland.
DOI: http://dx.doi.org/10.1016/j.ijnurstu.2015.09.015 |
AbstractBackground and objectives
Interdisciplinary geriatric consultation teams are implemented in the acute hospital setting in several high-income countries to provide comprehensive geriatric assessment for the increasing numbers of older patients with a geriatric profile hospitalized on non-geriatric units. Given the inconclusive evidence on this care model's effectiveness to improve patient outcomes, health care policy and practice oriented recommendations to redesign the structure and process of care provided by interdisciplinary geriatric consultation teams are needed. A scoping review was conducted to explore the structure and processes of interdisciplinary geriatric consultation teams in an international context. As nurses are considered key members of these teams, their roles and responsibilities were specifically explored.
Design
The revised scoping methodology framework of Arksey and O’Malley was applied.
Data sources
An electronic database search in Ovid MEDLINE, CINAHL and EMBASE and a hand search were performed for the identification of descriptive and experimental studies published in English, French or Dutch until April 2014.
Review methods
Thematic reporting with descriptive statistics was performed and study findings were validated through interdisciplinary expert meetings.
Results
Forty-six papers reporting on 25 distinct interdisciplinary geriatric consultation teams in eight countries across three continents were included. Eight of the 12 teams (67%) reporting on their composition, stated that nurses and physicians were the main core members with head counts varying from 1 to 4 members per profession. In 80% of these teams nurses were required to have completed training in geriatrics. Advanced practice nurses were integrated in eleven out of fourteen interdisciplinary geriatric consultation teams from the USA. Only 32% of teams used formal screening to identify patients most likely to benefit from their intervention, using heterogeneous screening methods, and scarcely providing information on the responsibilities of nurses. Nurses were involved in the medical, functional, psychological and social assessment of patients in 68% of teams, either in a leading role or in collaboration with other professions. Responsibilities of interdisciplinary geriatric consultation teams’ nurses regarding in-hospital follow-up or transitional care at hospital discharge were infrequently specified (16% of teams).
Conclusions
This scoping review identified that the structure and processes of care provided to geriatric patients by interdisciplinary geriatric consultation teams are highly heterogeneous. Despite nurses being key team members, only limited information on their specific roles and responsibilities was identified. More research in this area is required in order to inform health care policy and to formulate practice oriented recommendations to redesign the interdisciplinary geriatric consultation team care model aiming to improve its effectiveness.
Keywords:
Aged, Geriatric assessment, Geriatric nursing, Health services for the aged, Hospitals, Referral and consultation, Scoping review
رابط[عدل]
http://www.journalofnursingstudies.com/article/S0020-7489(15)00300-4/abstract
