140 / 210
S132
Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
patients (MN) presented higher ATn (7.7 vs 4.3, p 0.049) and lower
prevalence of caries (22.9% vs 26.7%, ns) and periodontal disease
(20% vs 23.3%, ns). However, toothbrushing (TB), toothpaste (TP) and
dental prosthesis (DP) utilization was related to better nutritional
status (TB: MN 40% vs 71.4%; TP: MN 40% vs 67.9%; DP: 22.8% vs
64.3%, p
<
0.005). Patients with dental prothesis showed a trend for
a higher mean triceps skinfold (20.8 vs 17.2, p = 0.07) and a lower
mean fat-free mass (Deurenberg equation) (36.9 vs 41.8, p = 0.08).
Conclusions:
Dental prosthesis, toothbrushing and toothpaste are
related to better nutritional status. Surprisingly, higher number of
natural teeth was associated to reduced lean mass. Further studies
are needed to clarify the role of natural dentiture in nutrition.
Organisation of care and gerotechnology
P-374
Improving patient care and confidence within the Multi
Disciplinary Team (MDT) by improving handover
G.S. Alg
John Radcliffe Hospital, Oxford, United Kingdom
Introduction:
In geriatric medicine we manage complex patients.
Most geriatric units hold morning board rounds and weekly MDT
meetings. New plans for patients are made on ward rounds and
are not always handed over to colleagues. At our unit Nurses and
health care assistants (HCA) change and handover in the afternoons
without Doctors. Patients’ health can change at any time and family
concerns and questions need to be addressed especially in the
afternoons when visiting times start. Would afternoon handover
improve patient care and staff satisfaction?
Methods:
Two questionnaires were done. The first questionnaire
was designed to understand what our colleagues felt about
afternoon handover. The nurses and HCAs were asked to choose an
intervention they felt would improve handover. The intervention
chosen by the majority was then implemented. Post intervention
another questionnaire was done to decide whether the intervention
improved the quality of patient handover and patient care.
Results:
Questionnaire 1 showed that 77.8% of nurses felt handover
was poor and compromised patient care. 88% thought patient
health was put at risk by poor handover. 56% suggested the presence
of a Doctor in nursing and HCA handover would be the best
intervention to improve handover.
Questionnaire 2 showed that 100% of nurses and HCAs felt the
presence of a doctor at afternoon handover was helpful, improved
patient care and reduced morbidity and mortality.
Conclusions:
Results suggest afternoon handover on Geriatric
units improve patient care, prevent prolonged inpatient stays and
reduce morbidity and mortality. It also increases satisfaction and
confidence within the MDT.
P-375
Telemedicine and geriatric teleconsultations between the
University Hospital of Nancy and retirement homes: current
situation after eight months of experimentation
J. Azzi
1
, C. Perret-Guillaume
2
, A. Benetos
3
1
CHRU Nancy, Nancy, France;
2
CHU de Nancy, Vandoeuvre-l`es-Nancy
Cedex, France;
3
France
Introduction:
To improve the medical care of institutionalized
elderly patients through advances in information and communi-
cation technologies, geriatric physicians of the University Hospital
of Nancy carried out, since July 2014, remote and live consultations
for retirement homes residents.
Objectives:
To analyze the progress and reasons for using
teleconsultations during the experimental phase of the project:
from July 1st 2014 to February 15th, 2015.
Method:
Data collection was performed retrospectively, from the
informations contained in the report of each consultation.
Results:
During the trial period, including two nursing homes for a
total of 167 residents, 47 teleconsultations were performed. There
were 37 different patients (28 women), 8 residents received several
“follow up” teleconsultations with reference to the initial medical
problem. The average age of the 37 patients was 86.7 years. Each
teleconsultation took place with the obligatory presence of the
geriatrician and the patient. The patient may be accompanied by
the nursing home physician and/or a nurse.
We recorded 52 reasons for using teleconsultations: neuropsychi-
atric problems (34%), skin disorders (31%), advice on optimizing
treatments taken by the patient (23.2%), help support patient in
palliative care (5.9%), “other reasons” (5.9%).
Conclusion:
This experiment shows that the need for geriatric
expertise is important in nursing homes. By enriching exchanges
among health professionals, telemedicine improves the links
between hospital and medico-social structures.
P-376
Online secure message use by elderly patients in a primary
care practice
A. Chandra
1
, F. North
1
1
Mayo Clinic, Rochester, United States of America
Objectives:
Some primary care practices have introduced online
patient portals that allow secure messaging between patients and
providers to improve access. It is unclear to what extent these
are utilized by the elderly. Our objective was to study the use of
electronic secure messaging by elderly patients in our primary care
practice.
Methods:
This was a retrospective analysis of secure message use
by patients 65 years and over that are followed by Department of
Employee and Community Health (ECH), Mayo Clinic, Rochester.
Data was obtained from administrative and electronic medical
record. We evaluated 37,330 secure messages recorded in 2012
for current ECH patients with research consent to determine
the proportion from patients 65 years and older. We analyzed a
computer generated random sample of 10% of messages to explore
patterns of use by the elderly.
Results:
34,050 messages were from 11,877 patients (90.8%) aged
under 65 years. The remaining 3,280 messages were from 1,197
patients aged 65 years or over (9.2%). Currently patients 65 years
and older comprise 14.7% of the ECH population. In a random
sample of secure messages by the elderly the content was related
to symptoms (41%), requests for prescriptions (13%), and tests or
consultations (22.6%).
Conclusion:
Electronic secure messaging using the online patient
portal was utilized by a fair proportion of the elderly in this study
and may be a viable option to improve access in primary care. There
is need to further study and address possible barriers to electronic
secure message use by the elderly.
P-377
Dysphagia in care homes
D. Curto Prieto
1
, B. Luengo
1
, C. Gonzalez
1
, G. Garcia
1
, N. Rodriguez
1
,
J. Alburquerque
1
1
Sanitas residencial-Bupa, Barcelona, Spain
Objectives:
In the daily work in care homes, dysphagia is a
syndrome which has a greatest impact on the quality of life of
people with dementia, families and staff, especially in their lasts
year of life.
The objective was to demonstrate that deliver high quality care to
residents with dementia, improve symptoms such as dysphagia,
improve quality of life and other aspects associated with the
development of dementia